Current through L. 2024, ch. 259
Section 36-502 - Powers and duties of the director of AHCCCS; rules; expenditure limitation; reporting requirements; definitionA. The administration is responsible for monitoring, overseeing and evaluating its contractors and the contracted agencies providing services under this chapter to ensure that the services are provided in a timely, clinically effective and efficient manner. The administration and its contractors shall monitor the performance of an agency providing services pursuant to this chapter. The administration shall take corrective action, which may include technical assistance, and impose civil penalties pursuant to section 36-2918, if appropriate, suspension and termination of contracts, for agencies that the administration finds to not be in compliance with county, state and federal laws and rules or to not be performing the services in a timely, effective and efficient manner.B. The director shall adopt rules that include standards for agencies other than the state hospital when providing services and shall prescribe forms as may be necessary for the proper administration and enforcement of this chapter. The rules shall be applicable to patients admitted to or treated in agencies, other than the state hospital, as set forth in this chapter and shall provide for periodic inspections of such agencies.C. The director shall adopt rules, if necessary, and prescribe reporting requirements and standards for contractors and contracted agencies to collect, report and analyze information and data for the purpose of understanding the clinical effectiveness of services provided by the various agencies pursuant to this chapter. The administration shall analyze the information and data collected semiannually and shall report annually to the governor, the president of the senate and the speaker of the house of representatives beginning on or before December 31, 2025. For the purposes of this subsection, the information and data shall identify and measure clinical outcomes in the past year of members who have received a designation of serious mental illness, including all of the following:1. The number of hospitalizations and rehospitalizations, the facilities where admissions occurred and the average length of stay by admitting diagnosis, for members for whom the administration or its contractor is the primary payor.2. The number and percentage of members with a mental health disorder and co-occurring substance use disorder diagnosis who were admitted, discharged and subsequently readmitted to an inpatient psychiatric facility within the preceding year, for members for whom the administration or its contractor is the primary payor.3. The number and percentage of members whose title XIX enrollment is placed in a no-pay status in a given year due to the member's incarceration status, stratified by the number of times enrollment is suspended.4. The number of members for whom the administration or its contractor is notified of a release from incarceration and for whom the administration or its contractor conducts reach-in services.5. The number of responses by the contracted crisis system that identify members with a serious mental illness designation, including:(a) The number of crisis phone line calls received.(b) The number of mobile teams dispatched.(c) The number of members seen at psychiatric urgent care centers.(d) The number of members with two or more distinct crisis system episodes.6. The number of member deaths, the death rate and the cause of death in the preceding year.7. The number of members who are homeless, unsheltered or inadequately housed and for what period of time, as identified through homeless management information system data or other available sources identified by the administration.8. The number of title XIX members or non-title XIX grant-funded members, separately delineated, who are: (a) Admitted to a behavioral health residential facility.(b) Discharged from a behavioral health residential facility.(c) For those members for whom the administration or its contractor is the primary payor, admitted to an inpatient psychiatric hospital within one year after discharge from the behavioral health residential facility.9. The number and percentage of members who:(a) Have received court-ordered treatment.(b) Have requested and received the removal of a serious mental illness designation.(c) Have received court-ordered treatment and are adherent to the court-ordered treatment.(d) Did not receive a single behavioral health service.10. The number of patients who have been discharged from the state hospital and admitted to a contracted psychiatric hospital within the preceding year.11. The number of members who have been evaluated for a serious mental illness eligibility determination, the number of members whose eligibility determination resulted in receiving a serious mental illness designation and the number of members whose eligibility determination resulted in not receiving a serious mental illness designation.12. The number of members who are also enrolled in medicare and when the member's medicare enrollment became known to the administration, separately reported by title XIX and non-title XIX members.D. The director shall adopt rules concerning the admission of patients and the transfer of patients between mental health treatment agencies other than the state hospital. A patient undergoing court-ordered treatment may be transferred from one mental health treatment agency to another in accordance with the rules of the director, subject to the approval of the court.E. The director may adopt rules concerning leaves, visits and absences of patients from evaluation agencies and mental health treatment agencies other than the state hospital.F. The total amount of state monies that may be spent in any fiscal year by the administration for mental health services pursuant to this chapter may not exceed the amount appropriated or authorized by section 35-173 for that purpose. This chapter does not impose a duty on an officer, agent or employee of this state to discharge a responsibility or create any right in a person or group if the discharge or right would require an expenditure of state monies in excess of the expenditure authorized by legislative appropriation for that specific purpose.G. The requirements of subsection C of this section shall be implemented not later than October 1, 2025. On or before December 31, 2024, the administration shall file an interim report with the governor, the president of the senate and the speaker of the house of representatives that describes the plan of the administration in completing the requirements of this section. On or before December 31, 2025, the administration shall file a report with the governor, the president of the senate and the speaker of the house of representatives confirming the implementation of the requirements of this section.H. For the purposes of this section, "member" has the same meaning prescribed in section 36-2901.Amended by L. 2024, ch. 163,s. 1, eff. 9/14/2024.Amended by L. 2015, ch. 195,s. 20, eff. 6/30/2016.