Bill Text: AZ SB1195 | 2018 | Fifty-third Legislature 2nd Regular | Engrossed
Bill Title: Application; emergency admission; nonevaluating hospitals
Spectrum: Partisan Bill (Republican 1-0)
Status: (Engrossed - Dead) 2018-03-21 - Assigned to House APPROP Committee [SB1195 Detail]
Download: Arizona-2018-SB1195-Engrossed.html
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Senate Engrossed |
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State of Arizona Senate Fifty-third Legislature Second Regular Session 2018
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SENATE BILL 1195 |
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AN ACT
amending sections 36‑501, 36‑520, 36‑521, Arizona Revised Statutes; Amending title 36, chapter 5, article 4, Arizona Revised Statutes, by adding sections 36‑521.01 and 36‑521.02; Amending sections 36‑522, 36‑523 and 36‑524, Arizona Revised Statutes; Amending title 36, chapter 5, article 4, Arizona Revised Statutes, by adding section 36‑524.01; amending sections 36‑525, 36‑526, 36‑527, 36‑528, 36‑529, 36‑530 and 36‑531, 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:
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 screening agency or evaluation agency by the person in charge of the evaluation agency.
3. "Chief medical officer" means the chief medical officer under the supervision of the superintendent of the state hospital.
4. "Contraindicated" means that access is reasonably likely to endanger the life or physical safety of the patient or another person.
5. "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.
6. "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.
7. "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.
8. "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.
9. "Department" means the department of health services.
10. "Detention" means the taking into custody of a patient or proposed patient.
11. "Director" means the director of the administration.
12. "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 not less than at least the following:
(i) Two licensed physicians, who shall be are qualified psychiatrists, if possible, or at least experienced in psychiatric matters, and 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, shall be 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.
13. "Evaluation agency" means a health care agency that is licensed by the department and that has been approved pursuant to this title, providing to provide those services required of such the agency by this chapter.
14. "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.
15. "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.
16. "Health care decision maker" has the same meaning prescribed in section 12‑2801.
17. "Health care entity" means a health care provider, the department, the administration or a regional behavioral health authority under contract with the administration.
18. "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.
19. "Independent evaluator" means a licensed physician, psychiatric and mental health nurse practitioner or psychologist selected by the person to be evaluated or by such the person's attorney.
20. "Informed consent" means a voluntary decision following 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.
21. "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.
22. "Licensed physician" means any medical doctor or doctor of osteopathy osteopathic medicine 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.
23. "Medical director of an evaluation agency" means the medical director of a screening agency, evaluation agency or mental health treatment agency who is a psychiatrist, or other licensed physician experienced in psychiatric matters, and 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.
24. "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.
24. "Medically ready for discharge" means that, though a person may have a mental disorder and is in need of screening, evaluation or treatment pursuant to this chapter, the person's medical condition is such that the person may be safely discharged from a nonevaluating hospital.
25. "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.
26. "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.
27. "Mental health treatment agency" means the state hospital or a health care agency that is licensed by the department and that provides those services that are required of the agency by this chapter.
28. "Nonevaluating hospital" means a health care agency that is not licensed by the department to and has not been approved pursuant to this chapter to provide those services required of an evaluating agency under this chapter.
28. 29. "Outpatient treatment" or "combined inpatient and outpatient treatment" means any treatment program not requiring continuous inpatient hospitalization.
29. 30. "Outpatient treatment plan" means a treatment plan that does not require continuous inpatient hospitalization.
30. 31. "Patient" means any person who is undergoing examination, evaluation or behavioral or mental health treatment under this chapter.
31. 32. "Peace officers" means sheriffs of counties, constables, marshals and policemen of cities and towns.
32. 33. "Persistent or acute disability" means a severe mental disorder that meets all of the following criteria:
(a) 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 that significantly impairs judgment, reason, behavior or capacity to recognize reality.
(b) 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.
(c) Has a reasonable prospect of being treatable by outpatient, inpatient or combined inpatient and outpatient treatment.
33. 34. "Prepetition screening" means the review of each application requesting court‑ordered evaluation, including an investigation of facts alleged in such an 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.
34. 35. "Prescribed form" means a form established by a court or the rules of the administration in accordance with the laws of this state.
35. 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.
36. 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.
37. 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.
38. 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 Arizona state board of nursing.
39. 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.
40. 41. "Psychologist" means a person who is licensed under title 32, chapter 19.1 and who is experienced in the practice of clinical psychology.
41. 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.
42. 43. "Regional behavioral health authority" has the same meaning prescribed in section 36‑3401.
43. 44. "Screening agency" means a health care agency that is licensed by the department and that provides those services required of such the agency by this chapter.
44. 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.
45. 46. "State hospital" means the Arizona state hospital.
46. 47. "Superintendent" means the superintendent of the state hospital.
Sec. 2. Section 36-520, Arizona Revised Statutes, is amended to read:
36-520. Application for evaluation; definition
A. Any responsible individual may apply for a court‑ordered evaluation of a person who is alleged to be, as a result of a mental disorder, a danger to self or to others or a person with a persistent or acute disability or a grave disability and who is unwilling or unable to undergo a voluntary evaluation. The application shall be made in the prescribed form and manner as adopted by the director.
B. The application for evaluation shall be presented to a screening agency and include all of the following data, if known:
1. The name, and address if known, of the proposed patient for whom evaluation is applied requested.
2. The proposed patient's age, date of birth, sex, race, marital status, occupation, social security number, present location, and dates and places of previous hospitalizations. ,
3. The names and addresses of the proposed patient's guardian, agent under a health care or mental health care power of attorney, spouse, next of kin and significant other persons. And
4. Other data that the director may require on the form to whatever extent that this data is known and is applicable to the proposed patient.
5. A statement of relevant history of the proposed patient's mental health treatment and compliance with treatment to the extent known by the applicant.
6. Copies of all documents relating to guardianship or powers of attorney that allow consent to inpatient psychiatric treatment, if available at the time of the application.
3. 7. The applicant's name, address and relationship of to the person who is applying for the evaluation proposed patient.
4. 8. A statement that the proposed patient is believed to be, as a result of a mental disorder, a danger to self or to others or a patient person with a persistent or acute disability or a grave disability and the facts on which this statement is based.
5. 9. A statement that the applicant believes that the proposed patient is in need of prepetition screening, evaluation, supervision, care and treatment and the facts on which this statement is based.
10. if the applicant believes that the proposed patient is likely to cause or endure serious physical harm or injury during the time it would take for completion of a prepetition screening report, the facts and information that are the basis of the applicant's belief.
11. The names and contact information of persons who have witnessed the behavior exhibited by the proposed patient on which the application is based. The screening agency may not deny or refuse to process an application because no other witnesses are identified.
C. The application shall be signed and notarized. For an application made by a peace officer or a health care provider who is licensed pursuant to title 32, chapter 13, 15, 17 or 19.1 or title 32, chapter 33, article 5 or 6, the original signature of the applicant on a copy of the application is acceptable, does not have to be notarized and may be submitted as the written application.
D. The screening agency shall offer assistance to the applicant in preparation of the application. If the applicant is not a medical professional, the screening agency shall assist the applicant to develop the relevant mental health history and factual background appropriate to complete the application. The screening agency shall do those things that are reasonably necessary to allow completion of the application within three days after initial contact by the applicant, excluding weekends and holidays. On receipt of the application, the screening agency shall immediately note on the front of the application the time and date of receipt and shall log this information in a record of applications received by the screening agency. The screening agency shall act as prescribed in section 36‑521 within forty‑eight hours of the filing of after receiving the application, excluding weekends and holidays. If the application is not acted upon on within forty‑eight hours, the reasons for not acting promptly shall be reviewed by the director of the screening agency or the director's designee.
E. If the applicant for the court‑ordered evaluation presents the person to be evaluated at the screening agency, the agency shall conduct a prepetition screening examination. Except in the case of an emergency evaluation, the person to be evaluated shall not be detained or forced to undergo prepetition screening against the person's will.
F. If the applicant for the court‑ordered evaluation does not present the person to be evaluated at the screening agency, the agency shall conduct the prepetition screening at the home of the person to be evaluated or at any other place the person to be evaluated is found. If prepetition screening is not possible, the screening agency shall proceed as prescribed in section 36‑521, subsection B.
G. If the person to be screened is located at a hospital, a screening agency may perform the screening and examination at the hospital in person by a mental health provider or by telemedicine if the hospital and the screening agency have the personnel and equipment to do so. All screenings conducted while the person is located at a hospital shall be preceded by providing to the person a written and oral statement that the screener is not affiliated with the hospital and is not providing medical services to the person and that the screening is not physician‑patient privileged information.
G. H. If a person is being treated by prayer or spiritual means alone in accordance with the tenets and practices of a recognized church or religious denomination by a duly accredited practitioner of that church or denomination, such the person may not be ordered evaluated, detained or involuntarily treated unless the court has determined that the person is, as a result of mental disorder, a danger to others or to self.
H. I. Court‑ordered evaluation or treatment pursuant to this chapter does not operate to change the legal residence of a patient.
I. J. If the application is not acted on because it has been determined that the proposed patient does not need an a screening or evaluation, the agency after a period of six months shall destroy the application and any other evidence of the application.
J. K. For the purposes of this section, "person" includes a person who:
1. Is under eighteen years of age.
2. Has been transferred to the criminal division of the superior court pursuant to section 8‑327 or who has been charged with an offense pursuant to section 13‑501.
3. Is under the supervision of an adult probation department.
Sec. 3. Section 36-521, Arizona Revised Statutes, is amended to read:
36-521. Prepetition screening procedures; preparation of petition for court‑ordered evaluation
A. On receiving the application for evaluation, the screening agency, before filing a petition for court‑ordered evaluation, shall provide prepetition screening within forty‑eight hours, excluding weekends and holidays, when possible to determine whether there is reasonable cause to believe the allegations of the applicant for the court‑ordered evaluation, whether the person will voluntarily receive evaluation at a scheduled time and place and whether the person has a persistent or acute disability or a grave disability or is likely to present a danger to self or others until the voluntary evaluation the person is in need of an evaluation as described in this section.
B. After prepetition screening has been completed, the screening agency shall prepare a report of opinions and conclusions. If prepetition screening is not possible, the screening agency shall prepare a report giving reasons why the screening was not possible and including opinions and conclusions of staff members who attempted to conduct prepetition screening or otherwise investigated the matter.
C. If the prepetition screening report indicates that there exists no reasonable cause to believe the allegations of the applicant for the court‑ordered evaluation, it shall no reasonable cause exists to believe the person is in need of an evaluation as described in this section, the report shall be reviewed by the medical director of the screening agency or the medical director's designee. The screening agency shall provide written information to the applicant and proposed patient concerning the involuntary screening, evaluation and treatment process and information about where mental health treatment may be obtained in the community if needed. The screening agency shall also provide written information about legal decision‑making such as powers of attorney and guardianships and where to obtain information about those issues.
D. If, based on the allegations of the applicant for the court‑ordered evaluation and the prepetition screening report or other information obtained while attempting to conduct a prepetition screening, the agency determines that there is reasonable cause to believe that the proposed 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 that the proposed patient is unable or unwilling to voluntarily receive evaluation or is likely to present a danger to self or to others, has a grave disability or will further deteriorate before receiving a voluntary evaluation, the agency shall prepare a petition for court‑ordered evaluation and shall file the petition, which shall be signed by the person who prepared the petition unless the county attorney performs these functions. If the agency determines that there is reasonable cause to believe that the person is in such a condition that without immediate hospitalization he is likely to harm himself or others, the agency shall take all reasonable steps to procure such hospitalization on an emergency basis.
D. On review of the application for evaluation, the screening report and other information obtained while attempting to conduct a screening, the following options shall be available to the screening agency If the screening agency determines that:
1. No reasonable cause exists to believe the person is in need of an evaluation as described in this section, the screening agency shall immediately issue a written notice. If the applicant is a nonevaluating hospital or health care provider, the written notice shall set forth the reasons for not proceeding with the petition for court‑ordered evaluation and immediately give a copy of the notice to the nonevaluating hospital or health care provider and, if requested, to the proposed patient. if the application for evaluation was not from a nonevaluating hospital or health care provider, the reasons for not proceeding with the petition for court‑ordered evaluation shall be provided to the applicant to the extent that providing an explanation does not conflict with state or federal laws protecting patient privacy. The notice shall be on a form prescribed by the director.
2. No reasonable cause exists to believe the allegations of the applicant for the person in need of an evaluation as described in this section but there is reasonable cause to believe that the proposed patient has a mental disorder, would benefit from further evaluation or treatment and is able and willing to pursue and take advantage of further private or public evaluation or treatment services available in the community, the screening agency shall recommend specific evaluation or treatment services and shall make a direct referral to a person, agency or organization providing behavioral health services in the proposed patient's area. the proposed patient may choose to voluntarily receive the services that are offered by the screening agency and for which the proposed patient is eligible on either an inpatient or outpatient basis.
3. The proposed patient is in need of an evaluation and is capable of consenting to and will undergo voluntary evaluation and is unlikely to present a danger to self or to others pending the voluntary evaluation, a voluntary evaluation may be performed as directed by the screening agency pursuant to section 36‑522.
4. There is reasonable cause to believe that the proposed patient is, as a result of a mental disorder, a danger to self or to others and is unwilling or unable to be voluntarily evaluated and that during the time necessary to complete the screening procedures set forth in section 36‑520 and this section the proposed patient is likely without immediate admission for evaluation to suffer serious physical harm or serious illness or is likely to inflict serious physical harm on another person, the screening agency may seek immediate admission in an evaluation agency pursuant to section 36‑524.
5. There is reasonable cause to believe that the proposed patient is, as a result of a mental disorder, a danger to self or to others or has a persistent or acute disability or a grave disability and that the proposed patient is unable or unwilling to voluntarily receive evaluation, the agency shall prepare a petition for court‑ordered evaluation and shall file the petition with the court. the petition for court‑ordered evaluation shall be signed by the person who prepared the petition unless the county attorney performs these functions.
E. The screening agency or evaluation agency may contact the county attorney in order to obtain assistance in preparing the petition for court‑ordered evaluation, and the screening agency or evaluation agency may request the advice and judgment of the county attorney in reaching a decision as to whether the court‑ordered evaluation is justified.
F. The county attorney may prepare or sign or file the petition if a court has ordered the county attorney to prepare the petition.
G. If a petition for court‑ordered evaluation alleges danger to others as described in section 36‑501, the screening agency or evaluation agency, before filing such a petition, shall contact the county attorney for a review of the petition. The county attorney shall examine the petition and make one of the following written recommendations:
1. That a criminal investigation is warranted.
2. That the screening agency or evaluation agency shall file the petition.
3. That no further proceedings are warranted. The screening agency or evaluation agency shall consider the recommendation in determining whether a court‑ordered evaluation is justified and shall include the recommendation with the petition if the screening agency or evaluation agency decides to file the petition with the court.
H. The petition shall be made in the form and manner prescribed by the director.
I. If a petition for court‑ordered evaluation is filed by a prosecutor pursuant to section 13‑4517, a prior application for court‑ordered evaluation or prescreening is not necessary.
Sec. 4. Section 36-522, Arizona Revised Statutes, is amended to read:
36-522. Voluntary evaluation
A. If the petition for court‑ordered evaluation is not filed because it has been determined that the proposed patient is capable of consenting to and will voluntarily receive an evaluation and is unlikely to present a danger to self or to others until pending the voluntary evaluation, the evaluation agency provided for by the county, or selected by the proposed patient, shall be immediately notified and shall provide evaluation of the proposed patient at a scheduled time and place within five days of the notice a voluntary evaluation may be performed. The evaluation may be performed by an evaluation agency provided for by the county or by a private mental health provider or mental health treatment agency that is licensed to perform such evaluations and that is selected by the proposed patient if the provider or agency accepts the proposed patient's insurance or the proposed patient is able to pay privately. The evaluation agency shall be immediately notified and shall provide the evaluation of the proposed patient at a scheduled time and place within five days after the notice. The voluntary evaluation may be on an inpatient or outpatient basis. The screening agency shall direct the proposed patient in writing, on a form prescribed by the director, to submit to an evaluation at the designated time and place and shall further advise the proposed patient that if the proposed patient does not or cannot so submit, and the screening agency has reasonable cause to believe that the proposed patient is a danger to self or a danger to others, has a persistent or acute disability or has a grave disability, and is likely to further deteriorate without evaluation or treatment, the proposed patient may be taken into custody by a peace officer and delivered to a screening agency or evaluation agency for screening or evaluation pursuant to this chapter.
B. Voluntary inpatient evaluation is subject to article 3 of this chapter.
B. The screening agency shall subsequently contact the evaluation agency to which the proposed patient was directed in subsection A of this section to determine whether the proposed patient participated in the evaluation as scheduled and to discuss the results of the evaluation. If the proposed patient fails to participate in the evaluation as scheduled, or the evaluation confirms that the proposed patient is likely to need court‑ordered treatment pursuant to this article, the screening agency may submit a petition for court‑ordered evaluation pursuant to section 36‑521.
C. Voluntary inpatient evaluation is subject to article 3 of this chapter. Voluntary outpatient evaluation shall conform is subject to the requirements of section 36‑530, subsection D and section 36‑531, subsections B, C and D. and Voluntary evaluation shall proceed only after the person to be evaluated has given consent to be evaluated by signing a form prescribed by the director that includes information to an acknowledgement by the proposed patient that the patient‑physician privilege does not apply and that the evaluation may result in a petition for the person to undergo court‑ordered treatment or for guardianship. Voluntary evaluation may be carried out only if chosen by the patient during the course of a prepetition screening after an application for evaluation has been made. Informed consent for inpatient evaluation may be given by the proposed patient or by the proposed patient's court‑appointed guardian with inpatient authority or designated agent under a power of attorney that includes authority to consent to inpatient evaluation or treatment. Informed consent for outpatient evaluation may be granted by the proposed patient or by the proposed patient's court‑appointed guardian or the proposed patient's designated agent under a power of attorney that includes authority to consent to outpatient evaluation or treatment.
Sec. 5. Section 36-523, Arizona Revised Statutes, is amended to read:
36-523. Petition for court‑ordered evaluation
A. The petition for court‑ordered evaluation shall contain the following:
1. The name, address and interest in the case of the individual who applied for the petition.
2. The name, and address if known, of the proposed patient for whom evaluation is petitioned.
3. The present whereabouts of the proposed patient, if known.
4. A statement alleging that there is reasonable cause to believe that the proposed patient has a mental disorder and is as a result a danger to self or to others, has a persistent or acute disability or a grave disability and is unwilling or unable to undergo voluntary evaluation.
5. A summary of the facts that support the allegations that the proposed patient is dangerous, has a persistent or acute disability or a grave disability and is unwilling or unable to be voluntarily evaluated, including the facts that brought the proposed patient to the screening agency's attention.
6. The names and contact information of any persons known who are acquainted with the proposed patient and who witnessed the behavior exhibited by the proposed patient on which the petition is based. The agency may not decline to process a petition for court‑ordered evaluation because no witnesses acquainted with the proposed patient are identified.
6. 7. If the petition is filed by a prosecutor pursuant to section 13‑4517, the petition shall include any known criminal history of the proposed patient, including whether the proposed patient has ever been found incompetent to stand trial pursuant to section 13‑4510.
7. 8. Other information that the director by rule or the court by rule or order may require.
B. The petition shall request that the court issue an order requiring that the proposed patient be given an evaluation and shall advise the court of both of the following:
1. That the opinion of the petitioner is either that the proposed patient is or is not in such a condition that without immediate or continuing hospitalization the proposed patient is likely to suffer serious physical harm or further deterioration or inflict serious physical harm on another person.
2. If the opinion of the petitioner is that the proposed patient is not in the condition described in paragraph 1 of this subsection, that the opinion of the petitioner is either that the evaluation should or should not take place on an outpatient basis.
C. The petition for court‑ordered evaluation shall be accompanied by the application for evaluation by the recommendation of the county attorney pursuant to section 36‑521 and by a prepetition any screening report, unless the documents have not been prepared under a provision of law or in accordance with an order of the court. The petition for court‑ordered evaluation shall also be accompanied by a copy of the application for emergency admission, if one exists.
D. A petition and other forms required in a court may be filed only by the screening agency or evaluation agency that has prepared the petition or by the county attorney pursuant to section 36‑521.
E. If the petition is not filed because it has been determined that the person does not need an a court‑ordered evaluation, the agency after a period of six months shall destroy the petition and the various reports annexed to the petition as required by this section.
F. If the petition is not filed because it has been determined that the person does not need an a court‑ordered evaluation and a prosecutor filed a petition pursuant to section 13‑4517, the person shall be remanded for a disposition pursuant to section 13‑4517. If the person is out of custody, the court may order that the person be taken into custody for a disposition pursuant to this section.
Sec. 6. Section 36-524, Arizona Revised Statutes, is amended to read:
36-524. Application for emergency admission for evaluation; requirements
A. A written application for emergency admission shall be made to an evaluation agency before a person may be hospitalized in admitted to the evaluation agency.
B. The application for emergency admission shall be made by a person with knowledge of the facts requiring emergency admission. The applicant may be a relative or friend of the person, a peace officer, the admitting officer or another responsible person. if the applicant is not a medical professional, the screening agency shall assist the applicant to develop the relevant mental health history and factual background appropriate to complete the application.
C. The application shall be upon made on a prescribed form and shall include the following:
1. A statement by the applicant that he believes on the basis of personal observation that there is reasonable cause to believe that the person is, as a result of a mental disorder, a danger to self or others, and is unable or unwilling to undergo voluntary evaluation and that, during the time necessary to complete the prepetition screening procedures set forth in sections 36‑520 and 36‑521 the person is likely without immediate hospitalization to suffer serious physical harm or serious illness or is likely to inflict serious physical harm upon on another person.
2. The specific nature of the danger.
3. A summary of the observations upon on which the statement of danger is based.
4. A summary of the facts and data, including observations of persons who witnessed the statements or behaviors that support the assertions in the application.
4. 5. The signature of the applicant.
D. A telephonic application may be made no not more than twenty‑four hours prior to before a written application. A telephonic application shall be made by or in the presence of a peace officer unless the application is made by a health care provider who is licensed pursuant to title 32, chapter 13, 15, 17 or 19.1 and who is directly involved with the care of a patient who is in a health care facility licensed in this state. For an application made by a doctor or a nurse peace officer or by a health care provider who is licensed pursuant to title 32, chapter 13, 15, 17 or 19.1 or title 32, chapter 33, article 5 or 6, the original signature of the applicant on a facsimile copy of the application that contains the applicant's original signature is acceptable, does not have to be notarized and may be submitted as the written application.
e. On receipt of the application, the evaluation agency shall immediately cause the time and date of the receipt of the application to be logged in a record of applications received by the evaluation agency. If the application is in writing, the evaluation agency shall also cause the time and date of receipt to be noted on the front of the application.
F. An application may be granted if the admitting officer determines there is reasonable cause to believe that the person is a danger to self or others as the result of a mental disorder and is unwilling or unable to undergo voluntary evaluation and that, during the time necessary to complete the screening procedures set forth in sections 36‑520 and 36‑521, the person is likely without immediate admission to an evaluation agency to suffer serious physical harm or serious illness or is likely to inflict serious physical harm on another person.
E. G. If the person to be admitted is not already present at the evaluation agency and if the admitting officer, based upon on review of the written or telephonic application and conversation with the applicant and peace officer involved, has reasonable cause to believe that an emergency examination admission for evaluation is necessary, the admitting officer may advise the peace officer, that sufficient grounds exist cause exists to take the person into custody and to transport the person to the evaluation agency. The admitting officer shall not be held civilly liable for any acts committed by a person whom the admitting officer did not advise be taken into custody if the admitting officer has in good faith followed the requirements of this section.
H. If the evaluation agency determines that no reasonable cause exists to believe that the proposed patient is in need of admission for emergency evaluation and that the application is to be denied, the denial must first be reviewed and approved by the medical director of the evaluation agency or the medical director's designee. The evaluation agency shall issue a written denial of the application to the applicant and the proposed patient stating the reasons the application is denied on a form prescribed by the director.
Sec. 7. Title 36, chapter 5, article 4, Arizona Revised Statutes, is amended by adding section 36-524.01, to read:
36-524.01. Application for emergency admission from a nonevaluating hospital
A. If the attending physician of a person admitted to or located at a nonevaluating hospital as an emergency patient or otherwise has reasonable cause to believe that the person is, as a result of a mental disorder, a danger to self or others and is in need of admission to an evaluation agency pursuant to section 36‑524, the nonevaluating hospital shall give the person a written notice on a form prescribed by the director that the nonevaluating hospital is filing an application for such an admission and shall cause the notice to be placed in the person's medical chart bearing the time and date of the notice's issuance and a written statement of the grounds on which the notice is issued. The nonevaluating hospital may hold the person for two hours after issuing the notice for the purposes of preparing and submitting an application to an evaluation agency.
B. If a written or telephonic application for emergency admission involves a patient who is currently admitted to or located at a nonevaluating hospital as an emergency patient or otherwise, within four hours after receiving the application the admitting officer shall review the application and make a determination to grant or deny the application as set forth in section 36‑524. The evaluation agency shall make the determination whether to grant or deny the application based on a review of the contents of the application, any available relevant medical records and, if practicable, an interview with the applicant and with any medical or hospital personnel directly involved with the patient and an interview with the proposed patient. The interview with the proposed patient may be conducted at the nonevaluating hospital in person by a mental health provider, or by telemedicine if the nonevaluating hospital and the evaluation agency have the personnel and equipment to do so. All interviews conducted while the person is located in a nonevaluating hospital shall be preceded by providing to the person a written and oral statement that the interviewer is not affiliated with the nonevaluating hospital and is not providing medical services to the person and that any statements made to the interviewer are not protected by physician‑patient privilege.
C. A patient may be involuntarily detained in a nonevaluating hospital or emergency room for the length of time necessary for a determination to be made on the application for emergency admission and to transport the patient for emergency admission for evaluation as set forth in this subsection.
D. If a proposed patient is not medically ready for discharge from the nonevaluating hospital at the time the application is granted, the proposed patient may not be transported to the evaluation agency until the nonevaluating hospital confirms that the proposed patient is medically ready for discharge from the nonevaluating hospital. The proposed patient may be detained at the nonevaluating hospital until medically ready for discharge. After the proposed patient is confirmed medically ready for discharge, the nonevaluating hospital shall immediately notify the evaluation agency in writing. The proposed patient may be held involuntarily at the nonevaluating hospital only for the length of time necessary to transport the person to the evaluation agency.
E. If the admitting officer determines, after doctor‑to‑doctor consultation with the proposed patient's attending physician or other physician at the nonevaluating hospital who is responsible for the proposed patient, that the proposed patient does not require emergency psychiatric hospitalization, the admitting officer shall immediately advise the nonevaluating hospital that the application is denied. The admitting officer of the evaluation agency or the admitting officer's designee shall issue a written statement as to the specific bases of the denial and shall immediately transmit the written denial to the nonevaluating hospital. the denial shall be logged in a record of applications received by the evaluation agency and shall be placed into the patient's medical chart.
F. The evaluation agency must arrange transportation within nine hours for a patient whose application for emergency evaluation has been granted and who is medically ready for discharge.
G. On receipt of the written denial from the evaluation agency, the person may no longer be detained in the hospital for reasons related to the nonevaluating procedures for court-ordered evaluation pursuant to this article and shall be discharged from a nonevaluating hospital absent reasons of medical necessity.
H. the admitting officer of the evaluation agency shall make a determination based on the information present pursuant to section 36‑524 and may not deny an application based on the possibility that there may be causes for the alleged behavior that have not yet been ruled out by additional medical testing.
Sec. 8. Section 36-525, Arizona Revised Statutes, is amended to read:
36-525. Apprehension and transportation by peace officers; immunity
A. A peace officer, on the advice of the admitting officer of the an evaluation agency pursuant to section 36‑524, subsection E, shall apprehend and transport a person to an evaluation agency.
B. In those instances in which If the procedures set forth in section 36‑524 are not available, a peace officer may take into custody any individual the peace officer has probable cause to believe is, as a result of mental disorder, a danger to self or to others, and that during the time necessary to complete the prepetition screening procedures set forth in sections 36‑520 and 36‑521 the person is likely without immediate emergency hospitalization admission for evaluation to suffer serious physical harm or serious illness or to inflict serious physical harm on another person. The peace officer shall transport the person to a screening agency unless the person's condition or the agency's location or hours makes such transportation impractical, in which event the person shall be transported to an evaluation agency. A peace officer is not held civilly liable for any acts committed by a person whom the peace officer has not taken into custody pursuant to this section.
C. If apprehension takes place on or about the premises of the apprehended person, the officer shall take reasonable precautions to safeguard the premises and the property thereon, unless such property and premises are in the possession of a responsible relative or guardian.
D. A peace officer who makes a good faith effort to follow the requirements of this section is not subject to civil liability.
Sec. 9. Section 36-526, Arizona Revised Statutes, is amended to read:
36-526. Emergency admission; examination; petition for court‑ordered evaluation
A. On presentation of the person for emergency admission pursuant to section 36‑524, an admitting officer of an evaluation agency shall perform an examination of the person's psychiatric and physical condition and may admit the person to the evaluation agency as an emergency patient if the admitting officer finds, as a result of the examination and investigation of the application for emergency admission, that there is reasonable cause to believe that the person, as a result of a mental disorder, is a danger to self or to others, and that during the time necessary to complete the prepetition screening procedures set forth in sections 36‑520 and 36‑521 the person is likely without immediate hospitalization to suffer serious physical harm or serious illness or to inflict serious physical harm on another person. If a person is hospitalized admitted pursuant to this section, the admitting officer may notify a screening agency and seek its assistance or guidance in developing alternatives to involuntary confinement and in counseling the person and his the person's family.
B. On the same or a succeeding the next court day, the medical director in charge of the agency shall file a petition for a court‑ordered evaluation, unless the person has been discharged or has become a voluntary patient. The petition need not comply with the provisions of this chapter requiring preparation and filing of a prepetition screening report but shall meet all other requirements and shall seek an appropriate order pursuant to section 36‑529.
Sec. 10. Section 36-527, Arizona Revised Statutes, is amended to read:
36-527. Discharge and release; relief from civil liability
A. A person taken into custody for emergency admission may not be detained longer than twenty‑four hours excluding weekends and holidays following such a detention unless a petition for court‑ordered evaluation is filed.
B. A person who is admitted for emergency evaluation may be released at any time if, in the opinion of the medical director in charge of the evaluation agency, release is appropriate. The medical director shall not be held civilly liable for any acts committed by a released patient if the medical director has in good faith followed the requirements of this article. The patient may continue care and treatment in the evaluation agency if he the patient signs a voluntary application or consent to further treatment or if the application or consent is signed by the patient's court‑appointed guardian with inpatient authority or agent under a power of attorney who has authority to consent to such treatment.
C. Unless it is established that the requirements of this article have not been complied with in good faith, a nonevaluating hospital and its agents, employees, contracted providers and medical professionals may not be held civilly liable for any period of involuntary detention or the discharge of any person in accordance with this article or for any act committed by a person who is released from the nonevaluating hospital in accordance with this article.
D. The admitting officer of an evaluation agency may not be held civilly liable for any act committed by a person whom the admitting officer did not advise be taken into custody if the admitting officer has in good faith followed the requirements of this article.
Sec. 11. Title 36, chapter 5, article 4, Arizona Revised Statutes, is amended by adding section 36-527.01, to read:
36-527.01. Transfer from nonevaluating hospitals; complex medical patients; procedures; emergency hearing
A. Each evaluation agency shall compile and maintain a list of medical conditions and treatments that cannot be properly provided for in the agency. This list shall be provided to local nonevaluating hospitals, be publicly accessible and be updated at least annually. If a patient requires a treatment that cannot be properly provided by the evaluation agency or has a condition on the list, the patient may be held at the nonevaluating hospital until a hearing is held and an order is issued pursuant to subsection F of this section.
B. If the admitting officer of an evaluation agency believes that the patient in the nonevaluating hospital has a condition or requires a treatment that is not on the list but that cannot be properly provided for by the agency, the physician at the evaluation agency shall consult with the treating physician at the nonevaluating hospital to determine whether the proposed patient may be transferred to and treated in the evaluation agency during the period required for court‑ordered evaluation and any hearing on a petition for court‑ordered treatment.
C. If the physician at the receiving agency and the treating physician at the nonevaluating hospital cannot agree on a transport plan or treatment plan, the medical directors of both facilities shall consult regarding the proposed patient's plan.
D. If there is still no agreement on the proposed patient's transport plan or treatment plan, the receiving agency shall provide the nonevaluating hospital with documentation listing the reasons the agency cannot receive and care for the patient.
E. The consultations set forth in subsections B and C of this section must occur within twenty‑four hours after receipt of the application for emergency admission.
F. If the proposed patient is not able to be placed in an evaluation agency for the purposes of evaluation pursuant to this article because the proposed patient's medical condition is such that the patient must remain in a nonevaluating hospital for medical treatment, the evaluation agency shall file a request for an emergency status conference with the court for the purpose of determining the procedural due process to be applied in the case. On receipt of the request, the court shall conduct a status conference on the same or next court day. The status conference may be held by electronic means. If the court determines that the medical condition of the person is such that compliance with the duties and time frames set forth in this article is not practicable, the court shall issue orders directing how and where to evaluate the proposed patient for the purposes of this section and further specifying time frames and any special procedures necessary to ensure that the evaluation and any subsequent hearing on a petition for court‑ordered treatment are accomplished in the shortest length of time reasonably necessary.
Sec. 12. Section 36-528, Arizona Revised Statutes, is amended to read:
36-528. Emergency patients; duties of agency; notification of guardian or family member; right to counsel
A. A person detained under emergency detention shall be offered treatment for his the person's mental disorder to which he may consent the person consents. The person shall not be treated for his a mental disorder without his the person's express consent, or unless consent to further treatment is signed by the patient's court‑appointed guardian with inpatient authority or agent under a power of attorney who has authority to consent to the treatment. except that Notwithstanding this subsection, pharmacotherapy, seclusion and mechanical or pharmacological restraints may be employed as emergency measures for the safety of the person or others pursuant to section 36‑513.
B. At the time a person is taken into custody for emergency evaluation, the medical director in charge of the evaluation agency shall, subject to the provisions of section 36‑504, shall notify the person's guardian or, if none, a member of the family other than a person who has made application for emergency evaluation, if known, of the person's presence at the agency.
C. At the earliest time possible during the evaluation, the evaluation agency shall inquire into the need to safeguard and preserve the person's personal property or premises. If no responsible relative or guardian is in possession of the property or premises, it the agency shall proceed pursuant to the provisions of section 36‑508, subsection C.
D. The person detained in an evaluation agency pursuant to this section shall be informed of his the person's rights as stated in this section and in article 2 of this chapter, including the right to consult an attorney. He The person shall be advised that if he the person cannot employ an attorney, the court will appoint one for him. The person shall be advised that if a petition for court‑ordered evaluation is filed, the court will appoint the person an attorney to consult with and, if he the person cannot employ his own counsel an attorney, to represent him the person.
Sec. 13. Section 36-529, Arizona Revised Statutes, is amended to read:
36-529. Order for evaluation; order for detention; hearing
A. If, from the review of the petition for court‑ordered evaluation, the court does not determine that the proposed patient is likely to present a danger to self or to others or further deteriorate before the proposed patient's hearing on court‑ordered treatment, but determines that there is reasonable cause to believe that the proposed patient is, as a result of a mental disorder, a danger to self or to others or has a persistent or acute disability or a grave disability, the court shall issue an order directing the proposed patient to submit to an evaluation at a designated time and place, specifying that the evaluation will take place on an inpatient or an outpatient basis. The court may also order that, if the person does not or cannot so submit, the person be taken into custody by a peace officer and delivered to an evaluation agency. If the court makes such a conditional order, it shall also make a conditional appointment of counsel for the person to become effective when and if the person is taken into custody pursuant to this section.
B. If, from review of the petition for court‑ordered evaluation, there is reasonable cause to believe that the proposed patient is, as a result of a mental disorder, a danger to self or to others or has a persistent or acute disability or a grave disability and that the person requires immediate or continued hospitalization before the proposed patient's hearing on court‑ordered treatment, the court shall order the proposed patient to be taken into custody and evaluated at an evaluation agency. The court shall promptly appoint counsel for the proposed patient. If an intercounty agreement authorizes the same, the court may order that the evaluation be conducted in another county, and the superior court in the county where the evaluation is conducted shall have concurrent jurisdiction to make appropriate orders concerning the proposed patient.
C. If the person is not taken into custody or if the evaluation pursuant to the order of the court under subsection A or B of this section is not initiated within fourteen days from after the date of the order, the order and petition for evaluation shall expire. If a prosecutor filed a petition pursuant to section 13‑4517, the court and the prosecuting agency shall receive notice of the expiration of the order for evaluation. The court may enter any orders necessary for further disposition pursuant to section 13‑4517, including a pickup order directing that the person be taken into custody. This subsection does not prevent any person from initiating another court-ordered evaluation of the person pursuant to this chapter.
D. If the person is involuntarily hospitalized, the person shall be informed by the person's appointed attorney of the right to a hearing to determine whether the person should be involuntarily hospitalized for evaluation and to be represented at the hearing by an attorney. If the person requests a hearing to determine whether the person should be involuntarily hospitalized during evaluation, the court shall schedule a hearing at its first opportunity.
Sec. 14. Section 36-530, Arizona Revised Statutes, is amended to read:
36-530. Evaluation and treatment
A. A person who is admitted to an evaluation agency shall receive an evaluation as soon as possible after the court's order for evaluation and, subject to the provisions of sections 36‑512 and 36‑513 concerning the person's right to refuse treatment, receive care and treatment as required by his the person's condition for the full period that he is hospitalized of hospitalization. A clinical record shall be kept for each person which that details all medical and psychiatric evaluations and all care and treatment received by the person.
B. A person receiving an evaluation on an inpatient basis will shall remain in the facility during the evaluation, which shall be completed in less than seventy‑two hours, excluding weekends and holidays.
C. A person who is being evaluated on an outpatient basis will shall not remain in the facility overnight but will shall be examined during the usual outpatient working hours of the facility on a schedule of appointments. The evaluation will shall be completed not later than the fourth day after the first appointment, excluding Saturdays, Sundays and holidays.
D. If a person who has been directed by court order to appear for evaluation does not appear, or in the case of an outpatient evaluation does not complete the appointments scheduled, the evaluation agency shall notify the court and the person's guardian, if any, of the known facts and circumstances and, if appropriate, request that the court order the patient to be taken into custody for evaluation on an inpatient basis.
Sec. 15. Section 36-531, Arizona Revised Statutes, is amended to read:
36-531. Evaluation; possible dispositions; release
A. A person who is being evaluated on an inpatient basis in an evaluation agency shall be released if, in the opinion of the medical director of the agency, further evaluation is not appropriate, unless the person applies for further care and treatment on a voluntary basis or consent to further treatment is signed by the patient's court‑ordered guardian with inpatient authority or agent under a power of attorney who has authority to consent to the treatment.
B. If it is determined on an evaluation of the patient's condition that the patient is, as a result of a mental disorder, a danger to self or to others or has a persistent or acute disability or a grave disability, the medical director in charge of the evaluation agency that provided the evaluation, unless the person applies for further care and treatment on a voluntary basis, or consent to further treatment is signed by the patient's court‑ordered guardian with inpatient authority or agent under a power of attorney who has authority to consent to the treatment, shall prepare, sign and file a petition for court‑ordered treatment unless the county attorney performs the functions of preparing, signing or filing the petition as provided in subsection C of this section.
C. The agency may contact the county attorney to obtain assistance in preparing the petition for court‑ordered treatment, and the agency may request the advice and judgment of the county attorney in reaching a decision as to whether court‑ordered treatment is justified.
D. A person who is being evaluated on an inpatient basis in an evaluation agency shall be released within seventy‑two hours, excluding weekends and holidays, from after the time that the person is hospitalized pursuant to a court order for evaluation, unless the person applies for further care and treatment on a voluntary basis or consent to further treatment is signed by the patient's court‑ordered guardian with inpatient authority or agent under a power of attorney who has authority to consent to the treatment, or unless a petition for court‑ordered treatment has been filed pursuant to subsection B of this section.
E. If a prosecutor filed a petition pursuant to section 13‑4517, the medical director of an evaluation agency shall provide notice within twenty‑four hours to the court and the prosecuting agency of the medical director's intention to release the person under this section. If the person has been remanded to an evaluation agency pursuant to section 13‑4517, the evaluation agency shall detain the person for an additional twenty‑four hours to allow for the provision of any required notices. The medical director shall provide the patient's records, including medical and treatment records, to the court and the prosecuting agency.
F. The administration may conduct jointly with a school district, directly or indirectly, an educational evaluation pursuant to sections 15‑765 and 15‑766 for nonadjudicated youth. The evaluation information may be shared by and among authorized personnel employed by the administration and the department of education, or authorized personnel from the local education agency, for purposes of ensuring the provision of special education and related services as required by the individuals with disabilities education act (20 United States Code sections 1400 through 1415).
