Senate Engrossed


crisis standards of care; requirements





State of Arizona


Fifty-fifth Legislature

First Regular Session











Amending Title 36, chapter 6, article 9, Arizona Revised Statutes, by adding section 36-791; relating to public health emergencies.





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

Section 1. Title 36, chapter 6, article 9, Arizona Revised Statutes, is amended by adding section 36-791, to read:

START_STATUTE36-791. Crisis standards of care plan; crisis guidelines or standards; requirements; modification of existing plan, guidelines or standards; definition

A. If the department of health services adopts or establishes a crisis standards of care plan or crisis guidelines or standards to address resource allocation when the demand for certain health care services exceeds the supply of necessary resources, the plan, guidelines or standards must include the following provisions:

1. The allocation of health care resource decisions shall be made on the basis of valuing all life.

2. A Patient or the patient's health care decision maker has the right to make the patient's health care choices.

3. Decisions on the allocation of health care resources may not discriminate on the basis of disability, age, race, religion, sex, veteran status or income status.

4. Health care providers may consider only short-term survival when making decisions regarding the allocation of health care resources.

5. Treatment resources may not be allocated based on any of the following:

(a) Quality of life judgments.

(b) Consideration of long-term mortality and long-term life expectancy.

(c) Resource intensity and duration of need due to disability or age.

6. Each patient has the right to an individualized assessment on the basis of the best available objective medical evidence and not on assumptions about the patient's perceived health, preexisting conditions or medical diagnosis.

7. Persons with disabilities and the aged have the right to reasonable modifications to ensure that all patients have equal access to medical care, including reasonable modification in patient assessment, communication and support needs due to disability or age.

8. A patient or the patient's family or health care decision maker has the right to appeal any triage decision.

B. A health care provider or health care institution staff member may not require a patient or the patient's health care decision maker to do either of the following:

1. Sign a do-not-resuscitate order.

2. Make a particular health care treatment decision.

C. The department of health services shall modify any existing crisis standards of care plan or crisis guidelines or standards within sixty days after the effective date of this section to comply with the requirements of this section.

D. Representatives of the state protection and advocacy agency and advocates for the aged shall be members of the state disaster medical advisory committee, which is responsible for developing the crisis standards of care and other incident-specific priorities and guidance for delivering health care and using scarce medical resources during a public health emergency.

E. For the purposes of this section, "short-term survival" means a near-term survival from the episode of care that directly resulted from the illness or injury that required hospitalization. END_STATUTE

Sec. 2. Emergency

This act is an emergency measure that is necessary to preserve the public peace, health or safety and is operative immediately as provided by law.