A.R.S. § 36-1604 — Arizona Code / Title 36 / Chapter 13 / Article 1 / Section 1604
36-1604 Bond of permittee
Status: in_force

36-1604. Bond of permittee

The governing body shall require each permittee to give a satisfactory bond in a principal amount not less than five hundred dollars, conditioned upon payment of all damages which may be caused to persons or property by reason of the display.
A.R.S. § 36-434 — Arizona Code / Title 36 / Chapter 4 / Article 2 / Section 434
36-434 Outdoor behavioral health care programs; licensing requirements; inspections
Status: in_force

36-434. Outdoor behavioral health care programs; licensing requirements; inspections

A. An outdoor behavioral health care program shall:

1. Comply with the requirements for a level 2 behavioral health residential agency, as established by the department by rule except as provided in subsection C of this section.

2. Obtain and maintain national accreditation as an outdoor behavioral health care program.

3. Ensure that the outdoor behavioral health program's personnel comply with the requirements of section 36-425.03.

B. In addition to the standards adopted pursuant to section 36-405, subsection A, the department may adopt rules to establish facility, equipment and sanitation standards for outdoor behavioral health care programs.

C. An outdoor behavioral health care program that does not use facilities is exempt from any facility standards applicable to a behavioral health service agency.

D. If the director determines that there is reasonable cause to believe an outdoor behavioral health care program is not adhering to the licensing requirements of this chapter, the director and any duly designated employee or agent of the director, including county health representatives and county or municipal fire inspectors, may enter on and into any area used by the outdoor behavioral health care program at any reasonable time to determine, consistent with standard medical practices or behavioral health practices, compliance with this chapter, rules adopted pursuant to this chapter and local fire ordinances or rules.

E. An application for licensure under this chapter constitutes permission for and complete acquiescence in any entry or inspection of any area used by the outdoor behavioral health care program during the pendency of the application and, if licensed, during the term of the license.

F. If an inspection reveals that the outdoor behavioral health care program is not adhering to the licensing requirements prescribed pursuant to this chapter, the director may take action authorized by this chapter.

G. An outdoor behavioral health care program whose license has been suspended or revoked pursuant to this section is subject to inspection on application for relicensure or reinstatement of license.
A.R.S. § 36-322 — Arizona Code / Title 36 / Chapter 3 / Article 3 / Section 322
36-322 Sealing a certificate
Status: in_force

36-322. Sealing a certificate

A. The state registrar shall seal a certificate and evidentiary documents when the state registrar amends the registered certificate.

B. Unless required by a court order and except as provided in section 36-340, the state registrar shall not issue a copy of a certificate or other record sealed pursuant to this section.
A.R.S. § 36-2903.01 — Arizona Code / Title 36 / Chapter 29 / Article 1 / Section 2903.01
36-2903.01 Additional powers and duties; report; definition
Status: in_force

36-2903.01. Additional powers and duties; report; definition

A. The director of the Arizona health care cost containment system administration may adopt rules that provide that the system may withhold or forfeit payments to be made to a noncontracting provider by the system if the noncontracting provider fails to comply with this article, the provider agreement or rules that are adopted pursuant to this article and that relate to the specific services rendered for which a claim for payment is made.

B. The director shall:

1. Prescribe uniform forms to be used by all contractors.  The rules shall require a written and signed application by the applicant or an applicant's authorized representative, or, if the person is incompetent or incapacitated, a family member or a person acting responsibly for the applicant may obtain a signature or a reasonable facsimile and file the application as prescribed by the administration.

2. Enter into an interagency agreement with the department to establish a streamlined eligibility process to determine the eligibility of all persons defined pursuant to section 36-2901, paragraph 6, subdivision (a).  At the administration's option, the interagency agreement may allow the administration to determine the eligibility of certain persons, including those defined pursuant to section 36-2901, paragraph 6, subdivision (a).

3. Enter into an intergovernmental agreement with the department to:

(a) Establish an expedited eligibility and enrollment process for all persons who are hospitalized at the time of application.

(b) Establish performance measures and incentives for the department.

(c) Establish the process for management evaluation reviews that the administration shall perform to evaluate the eligibility determination functions performed by the department.

(d) Establish eligibility quality control reviews by the administration.

(e) Require the department to adopt rules, consistent with the rules adopted by the administration for a hearing process, that applicants or members may use for appeals of eligibility determinations or redeterminations.

(f) Establish the department's responsibility to place sufficient eligibility workers at federally qualified health centers to screen for eligibility and at hospital sites and level one trauma centers to ensure that persons seeking hospital services are screened on a timely basis for eligibility for the system, including a process to ensure that applications for the system can be accepted on a twenty-four hour basis, seven days a week.

(g) Withhold payments based on the allowable sanctions for errors in eligibility determinations or redeterminations or failure to meet performance measures required by the intergovernmental agreement.

(h) Recoup from the department all federal fiscal sanctions that result from the department's inaccurate eligibility determinations.  The director may offset all or part of a sanction if the department submits a corrective action plan and a strategy to remedy the error.

4. By rule establish a procedure and time frames for the intake of grievances and requests for hearings, for the continuation of benefits and services during the appeal process and for a grievance process at the contractor level. Notwithstanding sections 41-1092.02, 41-1092.03 and 41-1092.05, the administration shall develop rules to establish the procedure and time frame for the informal resolution of grievances and appeals. A grievance that is not related to a claim for payment of system covered services shall be filed in writing with and received by the administration or the prepaid capitated provider or program contractor not later than sixty days after the date of the adverse action, decision or policy implementation being grieved.  A grievance that is related to a claim for payment of system covered services must be filed in writing and received by the administration or the prepaid capitated provider or program contractor within twelve months after the date of service, within twelve months after the date that eligibility is posted or within sixty days after the date of the denial of a timely claim submission, whichever is later.  A grievance for the denial of a claim for reimbursement of services may contest the validity of any adverse action, decision, policy implementation or rule that related to or resulted in the full or partial denial of the claim.  A policy implementation may be subject to a grievance procedure, but it may not be appealed for a hearing. The administration is not required to participate in a mandatory settlement conference if it is not a real party in interest. In any proceeding before the administration, including a grievance or hearing, persons may represent themselves or be represented by a duly authorized agent who is not charging a fee. A legal entity may be represented by an officer, partner or employee who is specifically authorized by the legal entity to represent it in the particular proceeding.

5. Apply for and accept federal funds available under title XIX of the social security act (P.L. 89-97; 79 Stat. 344; 42 United States Code section 1396 (1980)) in support of the system. The application made by the director pursuant to this paragraph shall be designed to qualify for federal funding primarily on a prepaid capitated basis.  Such funds may be used only for the support of persons defined as eligible pursuant to title XIX of the social security act or the approved section 1115 waiver.

6. At least thirty days before the implementation of a policy or a change to an existing policy relating to reimbursement, provide notice to interested parties.  Parties interested in receiving notification of policy changes shall submit a written request for notification to the administration.

7. In addition to the cost sharing requirements specified in subsection D, paragraph 4 of this section:

(a) Charge monthly premiums up to the maximum amount allowed by federal law to all populations of eligible persons who may be charged.

(b) Implement this paragraph to the extent permitted under the federal deficit reduction act of 2005 and other federal laws, subject to the approval of federal waiver authority and to the extent that any changes in the cost sharing requirements under this paragraph would permit this state to receive any enhanced federal matching rate.

C. The director is authorized to apply for any federal funds available for the support of programs to investigate and prosecute violations arising from the administration and operation of the system. Available state funds appropriated for the administration and operation of the system may be used as matching funds to secure federal funds pursuant to this subsection.

D. The director may adopt rules or procedures to do the following:

1. Authorize advance payments based on estimated liability to a contractor or a noncontracting provider after the contractor or noncontracting provider has submitted a claim for services and before the claim is ultimately resolved. The rules shall specify that any advance payment shall be conditioned on the execution before payment of a contract with the contractor or noncontracting provider that requires the administration to retain a specified percentage, which shall be at least twenty percent, of the claimed amount as security and that requires repayment to the administration if the administration makes any overpayment.

2. Defer liability, in whole or in part, of contractors for care provided to members who are hospitalized on the date of enrollment or under other circumstances. Payment shall be on a capped fee-for-service basis for services other than hospital services and at the rate established pursuant to subsection G of this section for hospital services or at the rate paid by the health plan, whichever is less.

3. Deputize, in writing, any qualified officer or employee in the administration to perform any act that the director by law is empowered to do or charged with the responsibility of doing, including the authority to issue final administrative decisions pursuant to section 41-1092.08.

4. Notwithstanding any other law, require persons eligible pursuant to section 36-2901, paragraph 6, subdivision (a), section 36-2931 and section 36-2981, paragraph 6 to be financially responsible for any cost sharing requirements established in a state plan or a section 1115 waiver and approved by the centers for medicare and medicaid services.  Cost sharing requirements may include copayments, coinsurance, deductibles, enrollment fees and monthly premiums for enrolled members, including households with children enrolled in the Arizona long-term care system.

E. The director shall adopt rules that further specify the medical care and hospital services that are covered by the system pursuant to section 36-2907.

F. In addition to the rules otherwise specified in this article, the director may adopt necessary rules pursuant to title 41, chapter 6 to carry out this article.  Rules adopted by the director pursuant to this subsection shall consider the differences between rural and urban conditions on the delivery of hospitalization and medical care.

G. For inpatient hospital admissions and outpatient hospital services on and after March 1, 1993, the administration shall adopt rules for the reimbursement of hospitals according to the following procedures:

1. For inpatient hospital stays from March 1, 1993 through September 30, 2014, the administration shall use a prospective tiered per diem methodology, using hospital peer groups if analysis shows that cost differences can be attributed to independently definable features that hospitals within a peer group share. In peer grouping the administration may consider such factors as length of stay differences and labor market variations. If there are no cost differences, the administration shall implement a stop loss-stop gain or similar mechanism.  Any stop loss-stop gain or similar mechanism shall ensure that the tiered per diem rates assigned to a hospital do not represent less than ninety percent of its 1990 base year costs or more than one hundred ten percent of its 1990 base year costs, adjusted by an audit factor, during the period of March 1, 1993 through September 30, 1994. The tiered per diem rates set for hospitals shall represent no less than eighty-seven and one-half percent or more than one hundred twelve and one-half percent of its 1990 base year costs, adjusted by an audit factor, from October 1, 1994 through September 30, 1995 and no less than eighty-five percent or more than one hundred fifteen percent of its 1990 base year costs, adjusted by an audit factor, from October 1, 1995 through September 30, 1996. For the periods after September 30, 1996 no stop loss-stop gain or similar mechanisms shall be in effect. An adjustment in the stop loss-stop gain percentage may be made to ensure that total payments do not increase as a result of this provision. If peer groups are used, the administration shall establish initial peer group designations for each hospital before implementation of the per diem system. The administration may also use a negotiated rate methodology. The tiered per diem methodology may include separate consideration for specialty hospitals that limit their provision of services to specific patient populations, such as rehabilitative patients or children. The initial per diem rates shall be based on hospital claims and encounter data for dates of service November 1, 1990 through October 31, 1991 and processed through May of 1992. The administration may also establish a separate reimbursement methodology for claims with extraordinarily high costs per day that exceed thresholds established by the administration.

2. For rates effective on October 1, 1994, and annually through September 30, 2011, the administration shall adjust tiered per diem payments for inpatient hospital care by the data resources incorporated market basket index for prospective payment system hospitals. For rates effective beginning on October 1, 1999, the administration shall adjust payments to reflect changes in length of stay for the maternity and nursery tiers.

3. Through June 30, 2004, for outpatient hospital services, the administration shall reimburse a hospital by applying a hospital specific outpatient cost-to-charge ratio to the covered charges. Beginning on July 1, 2004 through June 30, 2005, the administration shall reimburse a hospital by applying a hospital specific outpatient cost-to-charge ratio to covered charges.  If the hospital increases its charges for outpatient services filed with the Arizona department of health services pursuant to chapter 4, article 3 of this title, by more than 4.7 percent for dates of service effective on or after July 1, 2004, the hospital specific cost-to-charge ratio will be reduced by the amount that it exceeds 4.7 percent.  If charges exceed 4.7 percent, the effective date of the increased charges will be the effective date of the adjusted Arizona health care cost containment system cost-to-charge ratio.  The administration shall develop the methodology for a capped fee-for-service schedule and a statewide cost-to-charge ratio. Any covered outpatient service not included in the capped fee-for-service schedule shall be reimbursed by applying the statewide cost-to-charge ratio that is based on the services not included in the capped fee-for-service schedule. Beginning on July 1, 2005, the administration shall reimburse clean claims with dates of service on or after July 1, 2005, based on the capped fee-for-service schedule or the statewide cost-to-charge ratio established pursuant to this paragraph. The administration may make additional adjustments to the outpatient hospital rates established pursuant to this section based on other factors, including the number of beds in the hospital, specialty services available to patients and the geographic location of the hospital.

4. Except if submitted under an electronic claims submission system, a hospital bill is considered received for purposes of this paragraph on initial receipt of the legible, error-free claim form by the administration if the claim includes the following error-free documentation in legible form:

(a) An admission face sheet.

(b) An itemized statement.

(c) An admission history and physical.

(d) A discharge summary or an interim summary if the claim is split.

(e) An emergency record, if admission was through the emergency room.

(f) Operative reports, if applicable.

(g) A labor and delivery room report, if applicable.

Payment received by a hospital from the administration pursuant to this subsection or from a contractor either by contract or pursuant to section 36-2904, subsection I is considered payment by the administration or the contractor of the administration's or contractor's liability for the hospital bill. A hospital may collect any unpaid portion of its bill from other third-party payors or in situations covered by title 33, chapter 7, article 3.

5. For services rendered on and after October 1, 1997, the administration shall pay a hospital's rate established according to this section subject to the following:

(a) If the hospital's bill is paid within thirty days of the date the bill was received, the administration shall pay ninety-nine percent of the rate.

(b) If the hospital's bill is paid after thirty days but within sixty days of the date the bill was received, the administration shall pay one hundred percent of the rate.

(c) If the hospital's bill is paid any time after sixty days of the date the bill was received, the administration shall pay one hundred percent of the rate plus a fee of one percent per month for each month or portion of a month following the sixtieth day of receipt of the bill until the date of payment.

6. In developing the reimbursement methodology, if a review of the reports filed by a hospital pursuant to section 36-125.04 indicates that further investigation is considered necessary to verify the accuracy of the information in the reports, the administration may examine the hospital's records and accounts related to the reporting requirements of section 36-125.04. The administration shall bear the cost incurred in connection with this examination unless the administration finds that the records examined are significantly deficient or incorrect, in which case the administration may charge the cost of the investigation to the hospital examined.

7. Except for privileged medical information, the administration shall make available for public inspection the cost and charge data and the calculations used by the administration to determine payments under the tiered per diem system, provided that individual hospitals are not identified by name. The administration shall make the data and calculations available for public inspection during regular business hours and shall provide copies of the data and calculations to individuals requesting such copies within thirty days of receipt of a written request. The administration may charge a reasonable fee for the provision of the data or information.

8. The prospective tiered per diem payment methodology for inpatient hospital services shall include a mechanism for the prospective payment of inpatient hospital capital related costs. The capital payment shall include hospital specific and statewide average amounts. For tiered per diem rates beginning on October 1, 1999, the capital related cost component is frozen at the blended rate of forty percent of the hospital specific capital cost and sixty percent of the statewide average capital cost in effect as of January 1, 1999 and as further adjusted by the calculation of tier rates for maternity and nursery as prescribed by law.  Through September 30, 2011, the administration shall adjust the capital related cost component by the data resources incorporated market basket index for prospective payment system hospitals.

9. For graduate medical education programs:

(a) Beginning September 30, 1997, the administration shall establish a separate graduate medical education program to reimburse hospitals that had graduate medical education programs that were approved by the administration as of October 1, 1999. The administration shall separately account for monies for the graduate medical education program based on the total reimbursement for graduate medical education reimbursed to hospitals by the system in federal fiscal year 1995-1996 pursuant to the tiered per diem methodology specified in this section. The graduate medical education program reimbursement shall be adjusted annually by the increase or decrease in the index published by the global insight hospital market basket index for prospective hospital reimbursement.  Subject to legislative appropriation, on an annual basis, each qualified hospital shall receive a single payment from the graduate medical education program that is equal to the same percentage of graduate medical education reimbursement that was paid by the system in federal fiscal year 1995-1996. Any reimbursement for graduate medical education made by the administration shall not be subject to future settlements or appeals by the hospitals to the administration. The monies available under this subdivision shall not exceed the fiscal year 2005-2006 appropriation adjusted annually by the increase or decrease in the index published by the global insight hospital market basket index for prospective hospital reimbursement, except for monies distributed for expansions pursuant to subdivision (b) of this paragraph.

(b) The monies available for graduate medical education programs pursuant to this subdivision shall not exceed the fiscal year 2006-2007 appropriation adjusted annually by the increase or decrease in the index published by the global insight hospital market basket index for prospective hospital reimbursement. Graduate medical education programs eligible for such reimbursement are not precluded from receiving reimbursement for funding under subdivision (c) of this paragraph. Beginning July 1, 2006, the administration shall distribute any monies appropriated for graduate medical education above the amount prescribed in subdivision (a) of this paragraph in the following order or priority:

(i) For the direct costs to support the expansion of graduate medical education programs established before July 1, 2006 at hospitals that do not receive payments pursuant to subdivision (a) of this paragraph. These programs must be approved by the administration.

(ii) For the direct costs to support the expansion of graduate medical education programs established on or before October 1, 1999.  These programs must be approved by the administration.

(c) The administration shall distribute to hospitals any monies appropriated for graduate medical education above the amount prescribed in subdivisions (a) and (b) of this paragraph for the following purposes:

(i) For the direct costs of graduate medical education programs established or expanded on or after July 1, 2006.  These programs must be approved by the administration.

(ii) For a portion of additional indirect graduate medical education costs for programs that are located in a county with a population of less than five hundred thousand persons at the time the residency position was created or for a residency position that includes a rotation in a county with a population of less than five hundred thousand persons at the time the residency position was established. These programs must be approved by the administration.

(d) The administration shall develop, by rule, the formula by which the monies are distributed.

(e) Each graduate medical education program that receives funding pursuant to subdivision (b) or (c) of this paragraph shall identify and report to the administration the number of new residency positions created by the funding provided in this paragraph, including positions in rural areas.  The program shall also report information related to the number of funded residency positions that resulted in physicians locating their practices in this state.  The administration shall report to the joint legislative budget committee by February 1 of each year on the number of new residency positions as reported by the graduate medical education programs.

(f) Local, county and tribal governments and any university under the jurisdiction of the Arizona board of regents may provide monies in addition to any state general fund monies appropriated for graduate medical education in order to qualify for additional matching federal monies for providers, programs or positions in a specific locality and costs incurred pursuant to a specific contract between the administration and providers or other entities to provide graduate medical education services as an administrative activity. Payments by the administration pursuant to this subdivision may be limited to those providers designated by the funding entity and may be based on any methodology deemed appropriate by the administration, including replacing any payments that might otherwise have been paid pursuant to subdivision (a), (b) or (c) of this paragraph had sufficient state general fund monies or other monies been appropriated to fully fund those payments. These programs, positions, payment methodologies and administrative graduate medical education services must be approved by the administration and the centers for medicare and medicaid services. The administration shall report to the president of the senate, the speaker of the house of representatives and the director of the joint legislative budget committee on or before July 1 of each year on the amount of money contributed and number of residency positions funded by local, county and tribal governments, including the amount of federal matching monies used.

(g) Any funds appropriated but not allocated by the administration for subdivision (b) or (c) of this paragraph may be reallocated if funding for either subdivision is insufficient to cover appropriate graduate medical education costs.

10. Notwithstanding section 41-1005, subsection A, paragraph 9, the administration shall adopt rules pursuant to title 41, chapter 6 establishing the methodology for determining the prospective tiered per diem payments that are in effect through September 30, 2014.

11. For inpatient hospital services rendered on or after October 1, 2011, the prospective tiered per diem payment rates are permanently reset to the amounts payable for those services as of October 1, 2011 pursuant to this subsection.

12. The administration shall adopt a diagnosis-related group based hospital reimbursement methodology consistent with title XIX of the social security act for inpatient dates of service on and after October 1, 2014.  The administration may make additional adjustments to the inpatient hospital rates established pursuant to this section for hospitals that are publicly operated or based on other factors, including the number of beds in the hospital, the specialty services available to patients, the geographic location and diagnosis-related group codes that are made publicly available by the hospital pursuant to section 36-437. The administration may also provide additional reimbursement for extraordinarily high cost cases that exceed a threshold above the standard payment. The administration may also establish a separate payment methodology for specific services or hospitals serving unique populations.

H. The director may adopt rules that specify enrollment procedures, including notice to contractors of enrollment. The rules may provide for varying time limits for enrollment in different situations. The administration shall specify in contract when a person who has been determined eligible will be enrolled with that contractor and the date on which the contractor will be financially responsible for health and medical services to the person.

I. The administration may make direct payments to hospitals for hospitalization and medical care provided to a member in accordance with this article and rules.  The director may adopt rules to establish the procedures by which the administration shall pay hospitals pursuant to this subsection if a contractor fails to make timely payment to a hospital. Such payment shall be at a level determined pursuant to section 36-2904, subsection H or I.  The director may withhold payment due to a contractor in the amount of any payment made directly to a hospital by the administration on behalf of a contractor pursuant to this subsection.

J. The director shall establish a special unit within the administration for the purpose of monitoring the third-party payment collections required by contractors and noncontracting providers pursuant to section 36-2903, subsection B, paragraph 10 and subsection F and section 36-2915, subsection E.  The director shall determine by rule:

1. The type of third-party payments to be monitored pursuant to this subsection.

2. The percentage of third-party payments that is collected by a contractor or noncontracting provider and that the contractor or noncontracting provider may keep and the percentage of such payments that the contractor or noncontracting provider may be required to pay to the administration. Contractors and noncontracting providers must pay to the administration one hundred percent of all third-party payments that are collected and that duplicate administration fee-for-service payments. A contractor that contracts with the administration pursuant to section 36-2904, subsection A may be entitled to retain a percentage of third-party payments if the payments collected and retained by a contractor are reflected in reduced capitation rates. A contractor may be required to pay the administration a percentage of third-party payments that are collected by a contractor and that are not reflected in reduced capitation rates.

K. The administration shall establish procedures to apply to the following if a provider that has a contract with a contractor or noncontracting provider seeks to collect from an individual or financially responsible relative or representative a claim that exceeds the amount that is reimbursed or should be reimbursed by the system:

1. On written notice from the administration or oral or written notice from a member that a claim for covered services may be in violation of this section, the provider that has a contract with a contractor or noncontracting provider shall investigate the inquiry and verify whether the person was eligible for services at the time that covered services were provided. If the claim was paid or should have been paid by the system, the provider that has a contract with a contractor or noncontracting provider shall not continue billing the member.

2. If the claim was paid or should have been paid by the system and the disputed claim has been referred for collection to a collection agency or referred to a credit reporting bureau, the provider that has a contract with a contractor or noncontracting provider shall:

(a) Notify the collection agency and request that all attempts to collect this specific charge be terminated immediately.

(b) Advise all credit reporting bureaus that the reported delinquency was in error and request that the affected credit report be corrected to remove any notation about this specific delinquency.

(c) Notify the administration and the member that the request for payment was in error and that the collection agency and credit reporting bureaus have been notified.

3. If the administration determines that a provider that has a contract with a contractor or noncontracting provider has billed a member for charges that were paid or should have been paid by the administration, the administration shall send written notification by certified mail or other service with proof of delivery to the provider that has a contract with a contractor or noncontracting provider stating that this billing is in violation of federal and state law. If, twenty-one days or more after receiving the notification, a provider that has a contract with a contractor or noncontracting provider knowingly continues billing a member for charges that were paid or should have been paid by the system, the administration may assess a civil penalty in an amount equal to three times the amount of the billing and reduce payment to the provider that has a contract with a contractor or noncontracting provider accordingly. Receipt of delivery signed by the addressee or the addressee's employee is prima facie evidence of knowledge.  Civil penalties collected pursuant to this subsection shall be deposited in the state general fund. Section 36-2918, subsections C, D and F, relating to the imposition, collection and enforcement of civil penalties, apply to civil penalties imposed pursuant to this paragraph.

L. The administration may conduct postpayment review of all claims paid by the administration and may recoup any monies erroneously paid. The director may adopt rules that specify procedures for conducting postpayment review.  A contractor may conduct a postpayment review of all claims paid by the contractor and may recoup monies that are erroneously paid.

M. Subject to title 41, chapter 4, article 4, the director or the director's designee may employ and supervise personnel necessary to assist the director in performing the functions of the administration.

N. The administration may contract with contractors for obstetrical care who are eligible to provide services under title XIX of the social security act.

O. Notwithstanding any other law, on federal approval the administration may make disproportionate share payments to private hospitals, county operated hospitals, including hospitals owned or leased by a special health care district, and state operated institutions for mental disease beginning October 1, 1991 in accordance with federal law and subject to legislative appropriation. If at any time the administration receives written notification from federal authorities of any change or difference in the actual or estimated amount of federal funds available for disproportionate share payments from the amount reflected in the legislative appropriation for such purposes, the administration shall provide written notification of such change or difference to the president and the minority leader of the senate, the speaker and the minority leader of the house of representatives, the director of the joint legislative budget committee, the legislative committee of reference and any hospital trade association within this state, within three working days not including weekends after receipt of the notice of the change or difference. In calculating disproportionate share payments as prescribed in this section, the administration may use either a methodology based on claims and encounter data that is submitted to the administration from contractors or a methodology based on data that is reported to the administration by private hospitals and state operated institutions for mental disease. The selected methodology applies to all private hospitals and state operated institutions for mental disease qualifying for disproportionate share payments.

P. Disproportionate share payments made pursuant to subsection O of this section include amounts for disproportionate share hospitals designated by political subdivisions of this state, tribal governments and universities under the jurisdiction of the Arizona board of regents. Subject to the approval of the centers for medicare and medicaid services, any amount of federal funding allotted to this state pursuant to section 1923(f) of the social security act and not otherwise spent under subsection O of this section shall be made available for distribution pursuant to this subsection. Political subdivisions of this state, tribal governments and universities under the jurisdiction of the Arizona board of regents may designate hospitals eligible to receive disproportionate share payments in an amount up to the limit prescribed in section 1923(g) of the social security act if those political subdivisions, tribal governments or universities provide sufficient monies to qualify for the matching federal monies for the disproportionate share payments.

Q. Notwithstanding any law to the contrary, the administration may receive confidential adoption information to determine whether an adopted child should be terminated from the system.

R. The adoption agency or the adoption attorney shall notify the administration within thirty days after an eligible person receiving services has placed that person's child for adoption.

S. If the administration implements an electronic claims submission system, it may adopt procedures pursuant to subsection G of this section requiring documentation different than prescribed under subsection G, paragraph 4 of this section.

T. In addition to any requirements adopted pursuant to subsection D, paragraph 4 of this section, notwithstanding any other law, subject to approval by the centers for medicare and medicaid services, beginning July 1, 2011, members eligible pursuant to section 36-2901, paragraph 6, subdivision (a), section 36-2931 and section 36-2981, paragraph 6 shall pay the following:

1. A monthly premium of fifteen dollars, except that the total monthly premium for an entire household shall not exceed sixty dollars.

2. A copayment of five dollars for each physician office visit.

3. A copayment of ten dollars for each urgent care visit.

4. A copayment of thirty dollars for each emergency department visit.

U. Subject to the approval of the centers for medicare and medicaid services, political subdivisions of this state, tribal governments and any university under the jurisdiction of the Arizona board of regents may provide to the Arizona health care cost containment system administration monies in addition to any state general fund monies appropriated for critical access hospitals in order to qualify for additional federal monies.  Any amount of federal monies received by this state pursuant to this subsection shall be distributed as supplemental payments to critical access hospitals.

V. For the purposes of this section, "disproportionate share payment" means a payment to a hospital that serves a disproportionate share of low-income patients as described by 42 United States Code section 1396r-4.
A.R.S. § 36-2154 — Arizona Code / Title 36 / Chapter 20 / Article 1 / Section 2154
36-2154 Right to refuse to participate in abortion; abortion medication or emergency contraception
Status: in_force

36-2154. Right to refuse to participate in abortion; abortion medication or emergency contraception

A. A hospital is not required to admit any patient for the purpose of performing an abortion. A physician, or any other person who is a member of or associated with the staff of a hospital, or any employee of a hospital, doctor, clinic or other medical or surgical facility in which an abortion has been authorized, who states in writing an objection to the abortion on moral or religious grounds is not required to facilitate or participate in the medical or surgical procedures that will result in the abortion.

B. A pharmacy, hospital or health professional, or any employee of a pharmacy, hospital or health professional, who states in writing an objection to abortion, abortion medication, emergency contraception or any medication or device intended to inhibit or prevent implantation of a fertilized ovum on moral or religious grounds is not required to facilitate or participate in the provision of an abortion, abortion medication, emergency contraception or any medication or device intended to inhibit or prevent implantation of a fertilized ovum.  The pharmacy, hospital or health professional, or an employee of the pharmacy, hospital or health professional, shall return to the patient the patient's written prescription order.
A.R.S. § 36-551.01 — Arizona Code / Title 36 / Chapter 5.1 / Article 1 / Section 551.01
36-551.01 Persons with developmental disabilities; rights guaranteed
Status: in_force

36-551.01. Persons with developmental disabilities; rights guaranteed

A. A person with a developmental disability in this state shall not be denied as the result of the developmental disability the rights, benefits, and privileges guaranteed by the constitution and laws of the United States and the constitution and laws of this state. The rights of persons with developmental disabilities which are specifically enumerated in this chapter are in addition to all other rights enjoyed by such persons. The listing of rights is not exclusive or intended to limit in any way rights which are guaranteed to persons with developmental disabilities under state and federal laws.

B. Every person with a developmental disability has the right to protection from exploitation and abuse on the basis of a developmental disability.

C. Every person with a developmental disability who is provided residential care by the state has the right to live in the least restrictive alternative, as determined after an initial placement evaluation has been conducted for that person.

D. Every school-age person with a developmental disability has the right to receive publicly-supported educational services in accordance with the applicable specific education laws of the state.

E. An employer, employment agency or labor organization shall not deny a person equal employment opportunity because of developmental disability except under both of the following circumstances:

1. The denial is based on a bona fide occupational qualification reasonably necessary to the normal operation of the particular business or enterprise.

2. The person's developmental disability significantly impairs the person's ability to meet the qualifications for the position in question.

F. An owner, lessee, sublessee, assignee, or managing agent of or other person having the right to sell, rent or lease any real property or agency or employee of that person shall not refuse to sell, rent or lease to any person or group of persons solely on the basis of developmental disability.

G. Any person with a developmental disability requesting to be provided with developmental disability programs or services has the right, prior to receiving programs or services, to receive a placement evaluation to determine the need for developmental disability services and to determine the appropriate services for such person.

H. Persons with developmental disabilities have the right to presumption of legal competency in guardianship proceedings.

I. Persons with developmental disabilities have the right to fair compensation for labor.

J. Each client who has been accepted to receive developmental disability services has the right to receive a written individual program plan. Each plan shall be developed by appropriate department personnel with the participation of the client and the client's parent or guardian, if any, and shall be based on the relevant results of the placement evaluation.

K. Every client has the right to periodic review of the individual program plan to measure progress, to modify objectives and programs if necessary and to provide guidance and remediation techniques.

L. Each client and each parent or guardian of a minor client or the guardian of an adult client has the right to participate in the client's initial placement evaluation and periodic evaluations and to be informed in writing of the client's progress at reasonable intervals.  Whenever possible, the responsible person shall be given the opportunity to decide among several appropriate alternative services available to the client from the service provider.

M. The responsible person has the right to withdraw the client from developmental disability programs and services unless the client was assigned to the department by the juvenile court. If a client is assigned pursuant to section 36-559, subsection D, the client shall seek and receive the court's permission before the client may withdraw.

N. Clients have the right to be free from mistreatment, neglect and abuse by service providers.

O. Each client has the right to be free from unnecessary and excessive medication. Medication shall not be used as punishment, for the convenience of the staff, as a substitute for an individual program plan, or in quantities that interfere with the client's individual program plan. Prescription-only medication for each client shall be authorized only by the prescription of a physician and the administration of such medication shall be directed by a physician.

P. On admission for developmental disability services, each client and the client's parent or guardian, if any, shall be given written notice, if possible, and oral notice in their primary language, in a manner which can be easily understood, of the rights included in this chapter, including the right to administrative reviews. If written or oral language is not the primary mode of communication of the client or the client's parent or guardian, notice shall be given to that person in the primary mode of communication, if possible. However, if a client is manifestly unable to comprehend these rights, notice to the parent or guardian of a minor client or to the guardian of an adult client shall be sufficient.

Q. Persons with developmental disabilities who are residents in residential programs operated or supported by the department have the right to a humane and clean physical environment, the right to communication and visits and the right to personal property.

R. A child with a developmental disability has the right to appropriate services that are consistent with the child's written individual program plan. These services do not require the relinquishment or restriction of parental rights or custody except as prescribed in section 8-533. These services are subject to available appropriations if they are not mandated by federal law.

S. Any person with a developmental disability or the parent or guardian of a person with a developmental disability who believes that his rights, as established by this chapter or by the Constitution of the United States or the Constitution of Arizona, have been violated has a right to petition the superior court for redress unless other remedies exist under federal or state laws.
A.R.S. § 36-2907.14 — Arizona Code / Title 36 / Chapter 29 / Article 1 / Section 2907.14
36-2907.14 AHCCCS; contractors; opioid treatment programs; reimbursement; report; definitions
Status: in_force

36-2907.14. AHCCCS; contractors; opioid treatment programs; reimbursement; report; definitions

A. Pursuant to section 36-2907, the administration and its contractors may reimburse an opioid treatment program provider for enrolled members only if the provider demonstrates enforcement of each plan contained in the annual report pursuant to subsection B of this section and the administration approves the report pursuant to subsection C of this section.

B. An opioid treatment program provider that receives reimbursement from the administration or its contractors shall submit an annual report on a schedule that is prescribed by the administration and that contains all of the following:

1. A detailed security plan that incorporates standards from the substance abuse and mental health services administration and the United States drug enforcement administration. The plan shall include patient management strategies that are designed to reduce potential harm to patients and lower the risk of exposure to illicit transactions and other consequences of overcrowding and poor patient management.

2. A neighborhood engagement plan that outlines engagement with key stakeholders in the neighborhood in which the opioid treatment program is located, including homeowners' associations, school administrators, neighboring businesses, community organizations, the city or town council and local law enforcement. The plan shall include information about ensuring consideration of and response to reasonable safety, security and trash removal concerns, concerns regarding adequate parking for patients and staff and other matters of concern to the entities prescribed in this paragraph.

3. A comprehensive plan related to the care of all patients to demonstrate how the opioid treatment program ensures that appropriate standards of care are met for medication-assisted treatment, including dosing, the provision of or referral to appropriate counseling and behavioral therapy services and peer support services, as required by the substance abuse and mental health services administration. This plan shall include whether the opioid treatment program provides the therapy services directly or refers patients for services through a separate provider. If the program refers patients for services through a separate provider, the report shall include strategies employed to ensure patients are able to access referred services in a timely manner.

4. A community relations and education plan that includes policies and procedures to measure and minimize the negative impact the opioid treatment program may have on the community, to promote peaceful coexistence and to plan for change in the program and program growth, including:

(a) Considering community needs and impacts when selecting a site for the program or program growth.

(b) Considering community input on the potential impact the program may have on the community.

(c) Maintaining a clean and orderly facility that does not impede pedestrian or traffic flow.

(d) Communicating with community leaders to foster good community relations.

(e) Developing and implementing a community relations plan that is specified to the needs of the program within its community and that includes the following actions:

(i) Establishing a liaison with community representatives to share information about the program, the community and mutual concerns and issues.

(ii) Identifying program personnel who will function as community relations coordinators and define the goals and procedures of the community relations plan.

(iii) Serving as a community resource on substance use and related health and social issues as well as promoting the benefit of medication-assisted treatment in preserving the public health.

(iv) Soliciting community input about medication-assisted treatment and the program's presence in the community.

(v) Developing program policies and procedures to effectively address or resolve community problems, including patient loitering and medication diversion, and ensuring that program operations do not affect community life adversely.

(vi) Documenting community contacts and community relations efforts and evaluating the effectiveness of activities over time in addressing outstanding problems or deficiencies.

(vii) Disclosing the process for community contacts to notify the administration's clinical resolution unit of any unresolved problems or deficiencies that includes, if appropriate, coordination with the state opioid treatment authority.

(viii) Developing communication mechanisms that provide interested parties and potential patients with general information about the program outside of regular operating hours.

5. A current diversion control plan that contains specific measures to reduce the possibility of diversion of controlled substances from legitimate treatment use.

C. The administration shall post the reports received pursuant to subsection B of this section on its public website.  The administration shall notify each city or town in which an opioid treatment program is located of the posted report and allow the city or town thirty days to provide comments on the report.  The administration shall consider the city's or town's comments on the report and approve or reject the annual report within thirty days after the close of the comment period.  If the administration identifies areas of concern regarding compliance with state rules, federal regulations or administration policies, the administration must provide the opioid treatment program thirty days to revise the report.  The administration shall also take any appropriate regulatory action based on the deficiencies identified. If the opioid treatment program does not submit the report within the required timelines or does not demonstrate enforcement of each plan contained in the report, or if the administration does not approve the report initially or after the requested revision, the administration, with appropriate notification to the provider, shall suspend reimbursement by the administration or its contractors to the opioid treatment program until the report is approved.

D. On or before January 15 of each year, the administration shall submit a report to the governor, the president of the senate and the speaker of the house of representatives that summarizes the reports submitted pursuant to subsection B of this section.  A copy of the report shall be provided to the secretary of state.

E. For the purposes of this section:

1. "Medication-assisted treatment" has the same meaning prescribed in section 32-3201.01.

2. "Opioid treatment program" means a licensed and accredited program that is authorized to dispense medications for the treatment of opioid use disorders through highly structured protocols defined in federal regulations and state rules.
A.R.S. § 36-2239 — Arizona Code / Title 36 / Chapter 21.1 / Article 2 / Section 2239
36-2239 Ambulance services; rates; charges; adjustment; civil penalty
Status: in_force

36-2239. Ambulance services; rates; charges; adjustment; civil penalty

A. An ambulance service that applies to adjust its rates or charges shall automatically be granted a rate increase equal to the amount determined under section 36-2234, subsection G, if the ambulance service is so entitled.  An automatic rate adjustment that is granted pursuant to this subsection and that is filed on or before April 1 is effective June 1 of that year. The department shall notify the applicant and each health care services organization as defined in section 20-1051 of the rate adjustment on or before May 1 of that year.

B. Notwithstanding subsection E of this section, if the department does not hold a hearing within ninety days after an ambulance service applies to the department to adjust its rates or charges, the ambulance service may adjust its rates or charges to an amount not to exceed the amount sought by the ambulance service in its application to the department. An ambulance service shall not apply to adjust its rates or charges more than once every six months.

C. At the time the department holds a hearing on the rates or charges of an ambulance service pursuant to section 36-2234, the department may adjust the rates or charges adjusted by the ambulance service pursuant to subsection B of this section, but the adjustment shall not be retroactive.

D. Except as provided in subsection H of this section, an ambulance service shall not charge, demand or collect any remuneration for any service greater or less than or different from the rate or charge determined and fixed by the department as the rate or charge for that service. An ambulance service may charge for disposable supplies, medical supplies and medication and oxygen related costs if the charges do not exceed the manufacturer's suggested retail price, are uniform throughout the ambulance service's certificated area and are filed with the director.  An ambulance service shall not refund or limit in any manner or by any device any portion of the rates or charges for a service that the department has determined and fixed or ordered as the rate or charge for that service.

E. The department shall determine and render its decision regarding all rates or charges within ninety days after commencement of the applicant's hearing to adjust rates or charges. If the department does not render its decision as required by this subsection, the ambulance service may adjust its rates and charges to an amount that does not exceed the amounts sought by the ambulance service in its application to the department. If the department renders a decision to adjust the rates or charges to an amount less than that requested in the application and the ambulance service has adjusted its rates and charges higher than the adjustment approved by the department, within thirty days after the department's decision the ambulance service shall refund to the appropriate ratepayer the difference between the ambulance service's adjusted rates and charges and the rates and charges ordered by the department. The ambulance service shall provide evidence to the department that the refund has been made. If the ambulance service fails to comply with this subsection, the director may impose a civil penalty subject to the limits provided in section 36-2245.

F. An ambulance service shall charge the advanced life support base rate as prescribed by the director under any of the following circumstances:

1. A person requests an ambulance by dialing telephone number 911, or a similarly designated telephone number for emergency calls, and all of the following apply:

(a) The ambulance is staffed with at least one ambulance attendant.

(b) The ambulance is equipped with all required advanced life support medical equipment and supplies for the advanced life support attendants in the ambulance.

(c) The patient receives advanced life support services or is transported by the advanced life support unit.

2. Advanced life support is requested by a medical authority or by the patient.

3. The ambulance attendants administer one or more specialized treatment activities or procedures as prescribed by the department by rule.

G. An ambulance service shall charge the basic life support base rate as prescribed by the director under any of the following circumstances:

1. A person requests an ambulance by dialing telephone number 911, or a similarly designated telephone number for emergency calls, and all of the following apply:

(a) The ambulance is staffed with two ambulance attendants certified by this state.

(b) The ambulance is equipped with all required basic life support medical equipment and supplies for the basic life support medical attendants in the ambulance.

(c) The patient receives basic life support services or is transported by the basic life support unit.

2. Basic life support transportation or service is requested by a medical authority or by the patient, unless any provision of subsection F of this section applies, in which case the advanced life support rate applies.

3. For an interfacility transport when the ambulance is staffed with at least one ambulance attendant as defined in section 36-2201, paragraph 6, subdivision (a), (c), (d) or (e).

H. For each contract year, the Arizona health care cost containment system administration and its contractors and subcontractors shall provide remuneration for ambulance services for persons who are enrolled in or covered by the Arizona health care cost containment system in an amount equal to 68.59 percent of the amounts as prescribed by the department as of July 1 of each year for services specified in subsections F and G of this section and 68.59 percent of the mileage charges as determined by the department as of July 1 of each year pursuant to section 36-2232. The Arizona health care cost containment system administration shall annually adjust the Arizona health care cost containment system fee schedule according to the department's approved ambulance service rate in effect as of July 1 of each year. The rate adjustments made pursuant to this subsection are effective beginning October 1 of each year.

I. In establishing rates and charges, the director shall consider the following factors:

1. The transportation needs assessment of the medical response system in a political subdivision.

2. The medical care consumer price index of the United States department of labor, bureau of labor statistics.

3. Whether a review is made by a local emergency medical services coordinating system in regions where that system is designated as to the appropriateness of the proposed service level.

4. The rate of return on gross revenue.

5. Response times pursuant to section 36-2232, subsection A, paragraphs 3 and 4.

J. Notwithstanding section 36-2234, an ambulance service may charge an amount for medical assessment, equipment or treatment that exceeds the requirements of section 36-2205 if requested or required by a medical provider or patient.

K. Notwithstanding subsections D, F and G of this section, an ambulance service may provide gratuitous services if an ambulance is dispatched and the patient subsequently declines to be treated or transported.
A.R.S. § 36-495.06 — Arizona Code / Title 36 / Chapter 4.3 / Article 1 / Section 495.06
36-495.06 Fees
Status: in_force

36-495.06. Fees

A. The department shall charge and collect a nonrefundable fee for a regular or a renewal license.

B. The director shall establish by rule a fee schedule that does not exceed the cost to the department to conduct an on-site inspection, approve third party accreditation, verify information submitted with the application and other activities related to licensure of environmental laboratories pursuant to this chapter or rules adopted pursuant to this chapter. The fee schedule for application for a regular or renewal license shall be based on the types of compliance testing that the laboratory is licensed to provide.
A.R.S. § 36-2301 — Arizona Code / Title 36 / Chapter 23 / Article 1 / Section 2301
36-2301 Duty to promote life of fetus or embryo delivered alive; rules; judicial enforcement; civil action; damages; definitions
Status: in_force

36-2301. Duty to promote life of fetus or embryo delivered alive; rules; judicial enforcement; civil action; damages; definitions

A. If an abortion is performed and a human fetus or embryo is delivered alive, it is the duty of any physician performing such an abortion and any additional physician in attendance as required by section 36-2301.01 to see that all available means and medical skills are used to promote, preserve and maintain the life of such a fetus or embryo.

B. If an abortion is performed and a human fetus or embryo is delivered alive, the physician performing the abortion shall document and report to the department of health services the measures the physician performed to maintain the life of the fetus or embryo. If an abortion is performed and a human fetus or embryo with a lethal fetal condition is delivered alive, the physician performing the abortion shall also document and report to the department of health services the specific lethal fetal condition that was diagnosed before the performance of the abortion and that was confirmed by an examination performed after the human embryo or fetus was delivered alive.

C. Before an abortion of a human fetus or embryo diagnosed with a lethal fetal condition, the physician performing the abortion must comply with the requirements of section 36-2158, subsection A and shall also inform the woman, orally and in person, that if the fetus or embryo is delivered alive, the diagnosis must be confirmed after the delivery and the standard of care required in subsection D of this section must be given.

D. The director of the department of health services shall prescribe rules requiring an abortion clinic or a hospital that performs or induces an abortion at or after twenty weeks' gestational age as defined in section 36-2151 to establish, document and implement policies and procedures to ensure compliance with this section. At a minimum, these policies and procedures shall require that:

1. In the case of an abortion clinic, a person is designated to contact emergency services immediately at the birth of a fetus or embryo delivered alive to arrange transfer to a hospital.

2. At least one person who is trained in neonatal resuscitation is present in the room where the abortion takes place for any abortion performed or induced at or after twenty weeks' gestational age.

3. Establish a protocol for rapid neonatal resuscitation of a fetus or embryo delivered alive, including assessing respiration and heart rate, clearing secretions, positioning the airway, providing warmth, drying and administering oxygen as needed.

E. If an abortion is performed and a human fetus or embryo with a lethal fetal condition is delivered alive, and the protocol for rapid neonatal resuscitation of a fetus or embryo pursuant to subsection D of this section is complied with and any further treatment beyond what is prescribed pursuant to subsection D of this section will do no more than temporarily prolong the act of dying when death is imminent, no further treatment is required by this section.

F. A hospital that is not in substantial compliance with the rules or policies and procedures adopted pursuant to this section may be subject to the penalties and sanctions specified in sections 36-427 and 36-431.01.

G. An action to enforce this section shall be brought in the name of the state by the attorney general or the county attorney in the superior court in the county in which the violation occurred.

H. In addition to other remedies available under the common or statutory law of this state, any of the following persons may file a civil action to obtain appropriate relief for a violation of this section:

1. The mother of the human fetus or embryo delivered alive.

2. The father of the human fetus or embryo delivered alive, unless the pregnancy resulted from the plaintiff's criminal conduct.

3. A maternal grandparent of the human fetus or embryo delivered alive if the mother was not at least eighteen years of age at the time of the abortion, unless the pregnancy resulted from the plaintiff's criminal conduct.

I. A civil action filed pursuant to subsection H of this section shall be brought in the superior court in the county in which the woman on whom the abortion was performed resides and may be based on a claim that the failure to see that all available means and medical skills were used to promote, preserve and maintain the life of the human fetus or embryo was a result of simple negligence, gross negligence or wanton, wilful or intentional misconduct or any other legal standard of care.  Relief for a civil action filed pursuant to subsection H of this section may include any of the following:

1. Monetary damages for psychological, emotional and physical injuries resulting from the violation of this section.

2. Statutory damages in an amount equal to five thousand dollars or three times the cost of the abortion, whichever is greater.

3. Reasonable attorney fees and costs.

J. A civil action brought pursuant to this section must be initiated within six years after the violation occurred.

K. For the purposes of this section:

1. "Abortion" has the same meaning prescribed in section 36-2151.

2. "Delivered alive" means the complete expulsion or extraction from the mother of a fetus or embryo, regardless of the state of gestational development, who, after expulsion or extraction, whether or not the umbilical cord has been cut or the placenta is attached, shows any evidence of life, including one or more of the following:

(a) Breathing.

(b) A heartbeat.

(c) Umbilical cord pulsation.

(d) Definite movement of voluntary muscles.

3. "Lethal fetal condition" has the same meaning prescribed in section 36-2158.
A.R.S. § 36-183.01 — Arizona Code / Title 36 / Chapter 1 / Article 4 / Section 183.01
36-183.01 County hospital under board of health or hospital board; powers and duties
Status: in_force

36-183.01. County hospital under board of health or hospital board; powers and duties

A. In any county that maintains a hospital, the board of supervisors may delegate to a county board of health the responsibility to manage and operate the hospital or if the county has a population of more than one million persons according to the most recent United States decennial census, the board of supervisors or in the case of a county with a special health care district that is subject to section 48-5541.01, the board of directors of the district, by majority vote, may appoint a hospital board to perform that function. If the board of supervisors decides to appoint a hospital board, the board shall be composed of the following members:

1. A member of the board of supervisors who is chosen by the board of supervisors. This member shall act as board chairman.

2. The director of the county hospital, who is a nonvoting member.

3. A physician licensed pursuant to title 32, chapter 13 or 17. This member shall not be a county employee.

4. A professional nurse licensed pursuant to title 32, chapter 15. This member shall not be a county employee.

5. Each current president or chairman of the hospital's medical staff, who is a nonvoting member.

6. Five public members selected by the board of supervisors for their interest in health care. The public members shall be residents of different supervisorial districts.

7. Two additional public members selected by the board of supervisors, one who has financial expertise and one who has legal expertise.

B. The member of the hospital board from the board of supervisors shall serve at the pleasure of the board of supervisors but no longer than four years. Other members of the hospital board shall serve staggered four-year terms, but no member may serve more than two full terms. A vacancy occurring on the hospital board shall be filled by the board of supervisors appointing another qualified person to serve the remainder of the term.

C. The county board of health or the appointed hospital board may:

1. With the consent of the board of supervisors and at salaries fixed by the supervisors, appoint a hospital director, physicians and employees to perform the work of the hospital.

2. Advise the director of the hospital and request from that person the information it deems necessary.

3. Prescribe standards of medical care to be furnished by the hospital and make reasonable rules for the operation and maintenance of the hospital.

4. With the consent of the board of supervisors, prescribe the charges to be made by the hospital to persons able to pay in whole or in part for services furnished by the hospital.

5. Prepare and submit to the board of supervisors an annual statement of the financial affairs of the hospital and an estimate of the amounts required to meet the expenses of the hospital for the next fiscal year. The estimate shall include an estimate of the amount of money required for each item of expenditure by the hospital.

6. Make long-range plans for the hospital and the care of the indigent sick of the county.

7. Advise the board of supervisors on all matters relating to the county hospital and medical services furnished by the county.
A.R.S. § 36-409.01 — Arizona Code / Title 36 / Chapter 4 / Article 1 / Section 409.01
36-409.01 Joint training sessions; survey process; compliance
Status: in_force

36-409.01. Joint training sessions; survey process; compliance

A. The department shall establish an annual joint training session between supervisors, compliance officers and investigators who perform duties related to section 36-409 and each of the following:

1. Skilled nursing providers.

2. Assisted living providers.

B. The purpose of the joint training sessions is to report changes to the survey process and to educate both the compliance officers and the skilled nursing and assisted living providers on how compliance with the changes will be determined.  The joint training sessions may be conducted in person or remotely.

C. The department may receive and spend gifts, grants or donations to pay for the joint training sessions required by subsection A of this section.
A.R.S. § 36-1661 — Arizona Code / Title 36 / Chapter 13 / Article 5 / Section 1661
36-1661 Placing or leaving injurious drug or substance about habitation; classification
Status: in_force

36-1661. Placing or leaving injurious drug or substance about habitation; classification

A person who scatters, throws, places or leaves in or about a house or building used or occupied as the residence of any other person, or in or about a yard, lawn or enclosure connected therewith, a sample of any drug, medicine or substance injurious to health, is guilty of a class 2 misdemeanor.
A.R.S. § 36-2951 — Arizona Code / Title 36 / Chapter 29 / Article 2 / Section 2951
36-2951 Self-directed attendant care services; rules; definition
Status: in_force

36-2951. Self-directed attendant care services; rules; definition

A. Notwithstanding any law to the contrary, a person enrolled in the Arizona long-term care system may employ another person to provide self-directed attendant care services that would otherwise be considered within the scope of nursing care pursuant to title 32, chapter 15 if:

1. The person receiving these services is in stable condition, is not a resident in a medical facility and is competent to give directions to the attendant.

2. The person receiving these services has a functional disability and requires a service that could have been performed by that person except for the disability.

3. The attendant offers only services that are prescribed by the administration by rule.

B. The administration shall adopt rules prescribing the types of self-directed attendant care services that may be delivered pursuant to this section.  Before it adopts these rules, the administration shall submit the proposed rules to the state board of nursing for its review and approval.

C. For the purposes of this section, "self-directed attendant care" means a service provided by an attendant caregiver who is hired to provide personal care, homemaker and general supervision services to a participant in the Arizona long-term care system.
A.R.S. § 36-2804.06 — Arizona Code / Title 36 / Chapter 28.1 / Section 2804.06
36-2804.06 Expiration and renewal of registry identification cards and registration certificates; replacement
Status: in_force

36-2804.06. Expiration and renewal of registry identification cards and registration certificates; replacement

(Caution:  1998 Prop. 105 applies)

A. All registry identification cards and registration certificates expire two years after their date of issue.

B. A registry identification card of a nonprofit medical marijuana dispensary agent shall be canceled and the agent's access to the verification system shall be deactivated on notification to the department by a registered nonprofit medical marijuana dispensary that the nonprofit medical marijuana dispensary agent is no longer employed by or no longer volunteers at the registered nonprofit medical marijuana dispensary.

C. The department shall issue a renewal nonprofit medical marijuana dispensary registration certificate or an independent third-party laboratory certificate within ten days after receipt of the prescribed renewal application and renewal fee from a registered nonprofit medical marijuana dispensary or independent third-party laboratory if the dispensary's registration certificate or the laboratory's certificate is not under suspension and has not been revoked.

D. If a cardholder loses a registry identification card, the cardholder shall promptly notify the department. Within five days after the notification and on payment of a $10 fee, the department shall issue a new registry identification card with a new random identification number to the cardholder and, if the cardholder is a registered qualifying patient, to the registered qualifying patient's registered designated caregiver, if any.

E. On or before December 1, 2019, the department shall implement an electronic registry card program for registry identification cards, registration certificates, certificates and renewals. The electronic license program shall allow for the electronic verification and delivery of registry identification cards, registration certificates, certificates and renewals.
A.R.S. § 36-103.01 — Arizona Code / Title 36 / Chapter 1 / Article 1 / Section 103.01
36-103.01 Governmental units succeeded; statutory references to succeeded governmental units
Status: in_force

36-103.01. Governmental units succeeded; statutory references to succeeded governmental units

A. The department succeeds to the authority, powers, duties and responsibilities of the following:

1. State department of health.

2. Arizona health planning authority.

3. Crippled children's services.

4. Arizona state hospital.

5. Anatomy board.

B. In the Arizona Revised Statutes, references to the agencies and departments listed in subsection A of this section shall be deemed to be references to the department of health services or its appropriate organizational units.

C. In the Arizona Revised Statutes, references to the state board of health, when used in the context of and in connection with the adoption of rules, the appellate or original review of administrative decisions, or the approval of decisions by department officers, shall be references to the director of the department of health services. In all other places, references to the state board of health shall be references to the department of health services.

D. In this title, and in the Arizona Revised Statutes, references to the commissioner of health shall be references to the director of the department of health services.
A.R.S. § 36-554 — Arizona Code / Title 36 / Chapter 5.1 / Article 1 / Section 554
36-554 Powers and duties of director
Status: in_force

36-554. Powers and duties of director

A. The director shall:

1. Be responsible for developing and annually revising a statewide plan and initiating statewide programs and services for persons with developmental disabilities in locations where the programs and services are necessary, which shall include:

(a) Child services, which may include infant stimulation, developmental training for pre-school children and special education at Arizona training program facilities for school-age, children with developmental disabilities residing at Arizona training program facilities who do not attend public school.

(b) Adult services, in coordination with the vocational rehabilitation services of the department, which may include but not be limited to job training and training and adjustment services, job development and placement, sheltered employment and other nonvocational day activity services for adults.

(c) Residential services, including various community residential settings, Arizona training program facilities and state operated service centers which provide varying levels of supervision in accordance with the developmental disability levels of the persons placed at such settings, facilities or centers. The department shall contract with private profit or nonprofit agencies to provide appropriate residential settings for persons with developmental disabilities which provide for regular assistance and supervision of such persons and which provide varied developmental disability programs and services on or near the community residential setting.

(d) Resource services, which may include comprehensive evaluation services, information and referral services and outpatient rehabilitation and social development services. The department in providing developmental disability programs and services shall whenever practicable utilize qualified private contractors. In selecting private contractors, the department shall utilize those contractors which can clearly demonstrate an ability to perform such contract in accordance with standards and specifications adopted by the department.

2. Establish standards, provide technical assistance, and supervise all developmental disability programs and services operated by or supported by the department.

3. Coordinate the planning and implementation of developmental disability programs and activities, institutional and community, of all state agencies, provided this shall not be construed as depriving other state agencies of jurisdiction over, or the right to plan for, control, and operate programs that pertain to developmental disability programs but that fall within the primary jurisdiction of such other state agencies.

4. Periodically assess the effectiveness of the quality assurance system as required by 42 Code of Federal Regulations section 434.34 as it pertains to developmental disabilities programs.

5. License community residential settings pursuant to this chapter.

6. Develop rules establishing a procedure for handling complaints about community residential settings.

7. Inform in writing every parent or guardian of a client with a developmental disability residing at or transferring to a community residential setting of the complaint handling procedure.

8. As new community residential settings are developed over a period of time, reduce the clientele at Arizona training program facilities to those persons with developmental disabilities who are required to be in Arizona training program facilities because the community lacks an appropriate community residential setting that meets their individual needs or whose parents or legal guardians want them in an Arizona training program facility.

9. In conjunction with the division, individuals with developmental disabilities and their families, advocates, community members and service providers, develop, enhance and support environments that enable individuals with developmental disabilities to achieve and maintain physical well-being, personal and professional satisfaction, participation as family and community members and safety from abuse and exploitation.

10. Do all other things reasonably necessary and proper to carry out the duties and the provisions of this chapter.

11. Adopt rules regarding procurement procedures similar to those found in title 41, chapter 23.

B. Programs and services offered pursuant to subsection A, paragraph 1 of this section shall be provided in cooperation with public and private resources that can best meet the needs of persons with developmental disabilities and that are located in the community and in proximity to the persons being served.

C. The director may:

1. Establish nonresidential outpatient programs for placement, evaluation, care, treatment and training of persons with developmental disabilities residing in the community who are not eligible for public school programs, and who do not have access to other state supported programs providing equivalent services.

2. Develop cooperative programs with other state departments and agencies, political subdivisions of the state, and private agencies concerned with and providing services for persons with developmental disabilities.

3. Contract for the purchase of services with other state and local governmental or private agencies. Such agencies are authorized to accept and expend funds received pursuant to such contracts.

4. Stimulate research by public and private agencies, institutions of higher learning, and hospitals in the interest of the prevention of developmental disabilities and improved methods of care and training for persons with developmental disabilities.

5. Apply for, accept, receive, hold in trust or use in accordance with the terms of the grant or agreement any public or private funds or properties, real or personal, granted or transferred to it for any purpose authorized by this chapter.

6. Make and amend rules from time to time as deemed necessary for the proper administration of programs and services for the treatment of persons with developmental disabilities, for the admission of persons with developmental disabilities to the programs and services and to carry out the purposes of this chapter.
A.R.S. § 36-445.03 — Arizona Code / Title 36 / Chapter 4 / Article 5 / Section 445.03
36-445.03 Limitation of publication; identity of patient confidential
Status: in_force

36-445.03. Limitation of publication; identity of patient confidential

Any publication of the results of a review for the purposes provided in sections 36-445 and 36-445.01 shall be made only for the purposes provided in those sections and shall keep confidential the identity of any patient whose condition, care or treatment was a part thereof.
A.R.S. § 36-411 — Arizona Code / Title 36 / Chapter 4 / Article 1 / Section 411
36-411 Residential care institutions; nursing care institutions; home health agencies; fingerprinting requirements; exemptions; definitions
Status: in_force

36-411. Residential care institutions; nursing care institutions; home health agencies; fingerprinting requirements; exemptions; definitions

A. Except as provided in subsection F of this section, as a condition of licensure or continued licensure of a residential care institution, a nursing care institution or a home health agency and as a condition of employment in a residential care institution, a nursing care institution or a home health agency, employees and owners of residential care institutions, nursing care institutions or home health agencies, contracted persons of residential care institutions, nursing care institutions or home health agencies or volunteers of residential care institutions, nursing care institutions or home health agencies who provide medical services, nursing services, behavioral health services, health-related services, home health services or direct supportive services and who have not been subject to the fingerprinting requirements of a health professional's regulatory board pursuant to title 32 shall have a valid fingerprint clearance card that is issued pursuant to title 41, chapter 12, article 3.1 or shall apply for a fingerprint clearance card within twenty working days after employment or beginning volunteer work or contracted work.

B. A health professional who has complied with the fingerprinting requirements of the health professional's regulatory board as a condition of licensure or certification pursuant to title 32 is not required to submit an additional set of fingerprints to the department of public safety pursuant to this section.

C. Each residential care institution, nursing care institution and home health agency shall make documented, good faith efforts to:

1. Contact previous employers to obtain information or recommendations that may be relevant to a person's fitness to work in a residential care institution, nursing care institution or home health agency.

2. Verify the current status of a person's fingerprint clearance card.

3. Beginning January 1, 2025, verify that a potential employee is not on the adult protective services registry pursuant to section 46-459.  If a potential employee is found to be on the adult protective services registry, the residential care institution, nursing care institution or home health agency may not hire the potential employee.

4. On or before March 31, 2025, verify that each employee is not on the adult protective services registry pursuant to section 46-459.  If an employee is found to be on the adult protective services registry, the residential care institution, nursing care institution or home health agency shall take action to terminate the employment of that employee.

5. Beginning March 31, 2025, annually reverify that each employee is not on the adult protective services registry pursuant to section 46-459.

D. An employee, an owner, a contracted person or a volunteer or a facility on behalf of the employee, the owner, the contracted person or the volunteer shall submit a completed application that is provided by the department of public safety within twenty days after the date the person begins work or volunteer service.

E. Except as provided in subsection F of this section, a residential care institution, nursing care institution or home health agency shall not allow an employee to continue employment or a volunteer or contracted person to continue to provide medical services, nursing services, behavioral health services, health-related services, home health services or direct supportive services if the person has been denied a fingerprint clearance card pursuant to title 41, chapter 12, article 3.1, has been denied approval pursuant to this section before May 7, 2001 or has had a fingerprint clearance card suspended or revoked.

F. An employee, volunteer or contractor of a residential care institution, nursing care institution or home health agency who is eligible pursuant to section 41-1758.07, subsection C to petition the board of fingerprinting for a good cause exception and who provides documentation of having applied for a good cause exception pursuant to section 41-619.55 but who has not yet received a decision is exempt from the fingerprinting requirements of this section if the person provides medical services, nursing services, behavioral health services, health-related services, home health services or direct supportive services to residents or patients while under the direct visual supervision of an owner or employee who has a valid fingerprint clearance card.

G. If a person's employment record contains a six-month or longer time frame during which the person was not employed by any employer, a completed application with a new set of fingerprints shall be submitted to the department of public safety.

H. For the purposes of this section:

1. "Direct supportive services":

(a) Means services other than home health services that provide direct individual care and that are not provided in a common area of a health care institution, including:

(i) Assistance with ambulating, bathing, toileting, grooming, eating and getting in and out of a bed or chair.

(ii) Assistance with self-administration of medication.

(iii) Janitorial, maintenance, housekeeping or other services provided in a resident's room.

(iv) Transportation services, including van services.

(b) Does not include services provided by persons contracted directly by a resident or the resident's family in a health care institution.

2. "Direct visual supervision" means continuous visual oversight of the supervised person that does not require the supervisor to be in a superior organizational role to the person being supervised.

3. "Home health services" has the same meaning prescribed in section 36-151.
A.R.S. § 36-1805 — Arizona Code / Title 36 / Chapter 16 / Article 1 / Section 1805
36-1805 Annual reports; hearing
Status: in_force

36-1805. Annual reports; hearing

(Rpld. 1/1/27)

A. The department shall develop reporting requirements for each institution of higher education and health care institution participating in the Arizona nurse education investment program. The administration shall develop reporting requirements for the student nurse clinical rotation and licensed or certified nurse training program, and the licensed registered nurse transition to practice program. On or before December 31, 2023 and each December 31 thereafter, the department and administration shall provide a report to the governor, the president of the senate, the speaker of the house of representatives and the chairpersons of the health and human services committees of the senate and the house of representatives, or their successor committees, and shall provide a copy of the report to the secretary of state. Each report shall include or address the following:

1. The number of participating entities and who participated in each program.

2. The number of nurses who completed each educational and clinical training program.

3. The measurements developed by the department or administration on the expansion of the statewide health care workforce and retention rates of health care institutions.

4. The expansion of university and community college programs, including the number of additional nursing students in each educational program.

5. The number of new nurse preceptors at each health care institution, the number of students and licensed or certified nurses trained by the expansion of preceptors at each health care institution and the turnover rate of licensed or certified nurses within one year of hiring at each health care institution.

6. The number and identity of health care institutions and the number of nurses participating at each health care institution in the licensed registered nurse transition to practice program and the turnover rate of licensed registered nurses within one year of hiring at each participating health care institution.

7. Any other benchmarking and outcome reports developed by the department to measure the effectiveness of the programs established pursuant to this chapter.

B. The health and human services committees of the house of representatives and the senate, or their successor committees, shall conduct a hearing to review the reports.
A.R.S. § 36-420.04 — Arizona Code / Title 36 / Chapter 4 / Article 1 / Section 420.04
36-420.04 Emergency responders; patient information; hospitals; discharge planning; patient screenings; discharge document
Status: in_force

36-420.04. Emergency responders; patient information; hospitals; discharge planning; patient screenings; discharge document

A. An assisted living center or assisted living home that contacts an emergency responder on behalf of a resident shall provide to the emergency responder a written document that includes all of the following:

1. The reason or reasons the emergency responder was requested on behalf of the resident.

2. Whether the resident receives medication services and, if the resident has provided this information to the assisted living center or assisted living home, a list of all the resident's prescription and over-the-counter medications, their dosages and how frequently they are administered.

3. The name, address and telephone number of the resident's current pharmacy.

4. A list of any known allergies to any medications, additives, preservatives or materials like latex or adhesive.

5. The name and contact information for the resident's primary care physician and power of attorney or authorized representative.

6. Basic information about the resident's physical and mental conditions and basic medical history, such as having diabetes or a pacemaker or experiencing frequent falls or cardiovascular and cerebrovascular events, as well as dates of recent episodes, if known.

7. The point-of-contact information for the assisted living center or assisted living home, including the telephone number, if available, cell phone number and email address.  A point of contact must be available to respond to questions regarding the information provided twenty-four hours a day, seven days a week.

8. A copy of the resident's health insurance portability and accountability act release authorizing a receiving hospital to communicate with the assisted living center or assisted living home to plan for the resident's discharge.  This paragraph does not preclude a resident from revoking the resident's health insurance portability and accountability act release authorization.

9. A copy of the resident's advance directives, if any, on file at the assisted living center or assisted living home.  This paragraph does not preclude a resident from revoking or modifying the resident's advance directives.

B. The assisted living center or assisted living home must notify the resident's authorized representative that the resident was transported to a hospital and provide the name and location of the hospital.

C. Each assisted living center and assisted living home must maintain a standardized form for each resident that includes the information prescribed in subsection A of this section, except for the information prescribed in subsection A, paragraph 1 of this section, which shall be provided at the time the emergency responder is contacted.  Each assisted living center and assisted living home shall periodically update this form for each resident as necessary.

D. An assisted living center or assisted living home shall maintain a copy of the document provided to the emergency responder and documentation of the actions required by subsection B of this section for a period of two years after the date of the emergency.

E. If the emergency responder transports the resident to a hospital, the emergency responder shall provide a copy of the written document required by subsection A of this section to the receiving hospital.

F. To protect the health and safety of patients being transferred by a hospital to an assisted living center or assisted living home, a discharging hospital shall coordinate with the health care institution from which the patient has been transferred or the health care institution to which the patient will be discharged and shall provide a written discharge plan for each inpatient.  The discharge plan shall:

1. Be prepared by appropriate staff.

2. Include point-of-contact information for the discharging hospital, including a telephone number and, if available, An email address.  The hospital's point of contact shall monitor the telephone and, if available, the email address provided and shall promptly respond to any inquiry. For forty-eight hours after discharge, the discharging hospital's designated point of contact must be available to respond to the receiving assisted living center or assisted living home to assist in returning or admitting the patient to the facility and to clarify any needed information in the discharge plan. Hospitals shall have a qualified hospital representative respond to discharge plan questions received from the assisted living center or assisted living home.

3. Document the patient's discharge evaluation and provide an assessment of the patient's medical or health conditions, including:

(a) Any documented pressure injuries or ulcers, the location on the body and the assessed stage level.

(b) Cognitive or physical conditions or impairments.

(c) The patient's weight-bearing status.

(d) Specified dietary requirements, if applicable.

(e) Whether the patient requires continuous medical services or continuous or intermittent nursing services or restraints.

(f) Whether the patient requires specialized medical equipment or home health services and a copy of the hospital's orders for that equipment or those services.

(g) Follow-up health care services and other services recommended for the patient.

4. Include, if applicable, a copy of any prescription that was transmitted to the patient's current pharmacy as designated in subsection A of this section or the medication summary or medication instructions.  The copy of the prescription or medication summary or medication instructions shall include the patient's name, medication administration instructions and the signature of the prescriber or a record that the prescription was electronically signed by the prescriber.

5. Document that the hospital notified the receiving assisted living center or assisted living home of any new device orders for the patient.

6. Document that the discharging hospital notified the patient's authorized representative that the patient was discharged and provided the name, location and contact information of the receiving facility.

G. The discharging hospital shall contact the assisted living center or assisted living home from which the patient entered the hospital, after initial inpatient assessment, to discuss an evaluation of the patient's likely postdischarge health care needs. The hospital shall reevaluate and discuss with the assisted living center or assisted living home from which the patient entered the hospital the patient's condition, as appropriate, to identify changes to the patient's condition that may impact the patient's postdischarge health care needs, including recommendations, if any, by the hospital to transfer the patient to a different facility other than the facility from which the patient entered the hospital to address the patient's higher care needs.  The discharging hospital shall provide an opportunity for a patient screening before discharge by the assisted living center or assisted living home from which the patient entered the hospital or to which the patient is being referred. The assisted living center or assisted living home shall determine through a screening and a review of or discussion about medical records whether the patient's postdischarge care needs, including additional ordered services, are within the facility's scope of services. After receiving notification from the discharging hospital, the assisted living center or assisted living home shall perform the screening promptly. For on-site screenings, the staff of the assisted living center or assisted living home may be required to follow standard hospital security and identification requirements. If the assisted living center or assisted living home from which the patient entered the hospital can no longer meet the patient's needs, the facility shall provide documentation to the hospital demonstrating the reasons why the facility cannot accept the patient back to the facility.

H. For patients being transferred from a hospital to an assisted living center or assisted living home who have not previously been admitted to the assisted living center or assisted living home, the hospital shall coordinate with the assisted living center or assisted living home to allow time to expeditiously obtain documentation from a physician, registered nurse practitioner, registered nurse or physician assistant coordinating the level of care needed in the assisted living center or assisted living home.

I. For emergency department or observation patients, the hospital shall provide the assisted living center or assisted living home from which the patient entered the hospital with a point of contact, including a telephone number and, if available, an email address. The hospital's point of contact shall monitor the telephone and, if available, the email address provided and promptly respond to any inquiry. For forty-eight hours after discharge, the discharging hospital's designated point of contact must be available to respond to the receiving assisted living center or assisted living home to assist in returning or admitting the patient to the assisted living center or assisted living home and to clarify any needed information in the discharge plan. Hospitals shall have a qualified hospital representative respond to discharge plan questions received from the assisted living center or assisted living home. The hospital shall also provide the patient's assisted living center or assisted living home with any new prescription orders as prescribed in subsection F, paragraph 4 of this section, a record of medications administered and any identified follow-up care services recommended for the patient. The hospital shall provide the additional information outlined in subsection F, paragraph 3 of this section if the hospital determines it is applicable. An assisted living center or assisted living home from which the patient entered the hospital shall readmit the patient if the assisted living center or assisted living home can meet the care needs for the patient.

J. Each hospital shall develop a discharge document that encompasses the information outlined in subsection F of this section for inpatient discharges. The discharge document shall be provided to the assisted living center or assisted living home to which the patient is being discharged.
A.R.S. § 36-351 — Arizona Code / Title 36 / Chapter 3 / Article 5 / Section 351
36-351 Duties of the director; Arizona state library, archives and public records
Status: in_force

36-351. Duties of the director; Arizona state library, archives and public records

A. The director shall provide safe, secure and permanent preservation of vital records.  The director shall comply with preservation requirements, including the resolution necessary for authentic reproduction, established by the Arizona state library, archives and public records pursuant to section 39-101.

B. The director shall submit to the Arizona state library, archives and public records for permanent preservation, a copy of a person's:

1. Registered birth certificate seventy-five years after the person's birth.

2. Registered death certificate fifty years after the person's death.

C. Pursuant to section 41-151.09, subsection D, the Arizona state library, archives and public records shall provide access to registered birth certificates and registered death certificates submitted pursuant to subsection B of this section.

D. Each calendar year, the director shall reproduce on permanent media established by the Arizona state library, archives and public records pursuant to section 39-101, vital records registered for the calendar year including an index.  The director shall submit the vital records and index to the Arizona state library, archives and public records, which shall provide for the confidential safekeeping of the vital records and index.

E. The director of the Arizona state library, archives and public records is entitled to receive records, including sealed records, within one hundred and twenty days on receipt or creation by the department.  These electronic records shall be used only for archival or preservation purposes and may not be released or copied for other purposes.
A.R.S. § 36-1331 — Arizona Code / Title 36 / Chapter 11.3 / Article 1 / Section 1331
36-1331 Definitions
Status: in_force

36-1331. Definitions

In this chapter, unless the context otherwise requires:

1. "Eligible facility" means a health care institution that operates under a federalwide assurance for the protection of human subjects pursuant to 45 Code of Federal Regulations part 46 and that is subject to the federal federalwide assurance regulations, policies and guidelines, including renewals or updates.

2. "Eligible patient" means a patient who meets all of the following conditions:

(a) Has a life-threatening disease or condition or a severely debilitating illness, attested to by the patient's physician.

(b) Has considered all other treatment options currently approved by the United States food and drug administration.

(c) Has received a recommendation from the patient's physician for an individualized investigational treatment based on an analysis of the patient's genomic sequence, human chromosomes, deoxyribonucleic acid, ribonucleic acid, genes, gene products, such as enzymes and other types of proteins, or metabolites.

(d) Has given written informed consent for the use of the individualized investigational drug, biological product or device.

(e) Has documentation from the patient's physician that the patient meets the requirements of this paragraph.

3. "Individualized investigational treatment":

(a) Means a drug, biological product or device that is unique to and produced exclusively for use by an individual patient based on the patient's own genetic profile.

(b) Includes individualized gene therapy, antisense oligonucleotides and individualized neoantigen vaccines.

4. "Life-threatening disease or condition" means a disease or condition that both:

(a) Has a high likelihood of death unless the course of the disease or condition is interrupted.

(b) Has a potentially fatal outcome and for which the end point of clinical trial analysis is survival.

5. "Severely debilitating illness" means a disease or condition that causes major irreversible morbidity.

6. "Written informed consent" means a written document that is signed by a patient, the patient's parent if the patient is a minor, the patient's legal guardian or the patient's advocate designated by the patient, that is attested to by the patient's physician and a witness and that, at a minimum, includes all of the following:

(a) An explanation of the currently approved products and treatments for the disease or condition from which the patient suffers.

(b) An attestation that the patient concurs with the patient's physician in believing that all currently approved and conventionally recognized treatments are unlikely to prolong the patient's life.

(c) Clear identification of the specific proposed individualized investigational drug, biological product or device that the patient is seeking to use.

(d) A description of the potentially best and worst outcomes of using the individualized investigational drug, biological product or device and a realistic description of the most likely outcome, including the possibility that new, unanticipated, different or worse symptoms might result and that death could be hastened by the proposed treatment. The description shall be based on the physician's knowledge of the proposed treatment in conjunction with an awareness of the patient's condition.

(e) A statement that the patient's health plan or a third-party administrator and provider are not obligated to pay for any care or treatment consequent to the use of the individualized investigational drug, biological product or device unless specifically required to do so by law or contract.

(f) A statement that the patient's eligibility for hospice care may be withdrawn if the patient begins curative treatment with the individualized investigational drug, biological product or device and that care may be reinstated if this treatment ends and the patient meets hospice eligibility requirements.

(g) A statement that the patient understands that the patient is liable for all expenses consequent to the use of the individualized investigational drug, biological product or device and that this liability extends to the patient's estate unless a contract between the patient and the manufacturer of the drug, biological product or device states otherwise.
A.R.S. § 36-3710 — Arizona Code / Title 36 / Chapter 37 / Article 1 / Section 3710
36-3710 Conditional release to a less restrictive alternative; conditions; reports; review
Status: in_force

36-3710. Conditional release to a less restrictive alternative; conditions; reports; review

A. If the court determines that conditional release to a less restrictive alternative is in the best interest of the person and will adequately protect the community and the court determines that the minimum conditions under section 36-3711 are met, the court shall enter judgment and order the person's conditional release to a less restrictive alternative.

B. The court may impose any additional conditions on the person that the court determines are necessary to ensure the person's compliance with treatment and to protect the community. If the court finds that conditions do not exist that will both ensure the person's compliance with treatment and protect the community, the court shall remand the person to the custody of the superintendent of the state hospital for care, supervision or treatment in a licensed facility that is under the supervision of the superintendent.

C. If the provider that is designated to provide inpatient or outpatient treatment or to monitor or supervise any other terms and conditions of a person's placement in a less restrictive alternative is not the state hospital, the provider shall agree in writing to provide the treatment.

D. Before the court authorizes a person's conditional release to a less restrictive alternative, the court shall impose any conditions on the person that the court determines are necessary to ensure the safety of the community. The conditions shall include that prior to release to a less restrictive alternative, a person shall be required to submit to ninety days of inpatient evaluation at the Arizona state hospital. At the discretion of the superintendent of the state hospital, the duration of the evaluation period may be less than ninety days. The court shall order the superintendent of the state hospital to investigate the less restrictive alternative and to submit additional conditions to the court. The court shall give a copy of the conditions of release to the person and to any designated service provider. Other conditions may include any of the following:

1. Specification of a residence.

2. Prohibition on any contact with potential or past victims.

3. Prohibition on the use of alcohol and other drugs.

4. Supervision by the department of health services or the county probation department if the person is serving a term of probation.

5. A requirement that the person remain in this state unless the person receives prior authorization from the court.

6. Other conditions that the court or the superintendent of the state hospital determines are in the best interest of the person or others.

E. Following a determination that a person's release to a less restrictive alternative is warranted and after considering the recommendation regarding the duration and amount of treatment by the superintendent of the state hospital, the court shall require as a condition of release to a less restrictive alternative, that the person participate in outpatient treatment. The outpatient supervision and treatment may include monitoring a person by use of a polygraph or plethysmograph or both. The treatment shall continue until the court orders a change in the person's treatment requirements or the person is discharged pursuant to section 36-3714.

F. Each month or as otherwise directed by the court, each designated service provider shall submit a report that states if the person is complying with the terms and conditions of the conditional release to a less restrictive alternative to:

1. The court.

2. The facility from which the person was released.

3. The county attorney in the county where the person was found to be a sexually violent person or to the attorney general.

G. The court shall review the case of each person who is conditionally released to a less restrictive alternative within one year after the person's release and thereafter on motion of either party or the superintendent of the state hospital or on the court's own motion until the person is discharged. At a case review, the court shall determine only if the person shall continue to be conditionally released to a less restrictive alternative. In making its determination, the court shall consider the periodic reports that are submitted to the court pursuant to subsection F of this section and the opinions of the superintendent of the state hospital and any other competent professional.

H. If a person is conditionally released to a less restrictive alternative, the department of health services shall notify the department of public safety of the person's release so that the department of public safety can commence any notification process as provided in section 13-3825.
A.R.S. § 36-335 — Arizona Code / Title 36 / Chapter 3 / Article 3 / Section 335
36-335 Birth registration for foundlings
Status: in_force

36-335. Birth registration for foundlings

A. A person who has custody of a foundling shall submit to the state registrar or to the local registrar or a deputy local registrar of the registration district where the foundling was found the following information:

1. The date the foundling was found.

2. The location where the foundling was found.

3. The sex, approximate race and approximate age of the foundling.

4. The name and address of the person who has custody of the foundling.

5. The name given to the foundling by the person who has custody of the foundling.

6. Any other data required by rules adopted pursuant to this chapter.

B. The state registrar shall create and register a birth certificate for a foundling and enter on the birth certificate the following information:

1. The location where the foundling was found as the place of birth.

2. The date of birth based on the approximate age of the foundling.

C. A person who has custody of a foundling and determines the foundling's identity shall notify the state registrar in writing of the determination.

D. If the identity of a foundling is determined, the state registrar shall seal the foundling's registered birth certificate and provide access to the foundling's registered birth certificate only pursuant to a court order issued in this state.
A.R.S. § 36-551 — Arizona Code / Title 36 / Chapter 5.1 / Article 1 / Section 551
36-551 Definitions
Status: in_force

36-551. Definitions

In this chapter, unless the context otherwise requires:

1. "Adaptive behavior" means the effectiveness or degree to which a person meets the standards of personal independence and social responsibility expected of the person's age and cultural group.

2. "Adult developmental home" means a residential setting in a family home in which the care, physical custody and supervision of the adult client are the responsibility, under a twenty-four-hour care model, of the licensee who, in that capacity, is not an employee of the division or of a service provider and the home provides the following services for a group of siblings or up to three adults with developmental disabilities:

(a) Room and board.

(b) Habilitation.

(c) Appropriate personal care.

(d) Appropriate supervision.

3. "Adult household member":

(a) Means a person who is at least eighteen years of age and who resides in an adult developmental home, child developmental home or other home and community based service setting for at least thirty days or who resides in the household throughout the year for more than a cumulative total of thirty days.

(b) Does not include a person who is receiving developmental disabilities services from the department.

4. "Advisory council" means the developmental disabilities advisory council.

5. "Arizona training program facility" means a state-operated institution for clients of the department with developmental disabilities.

6. "Attributable to cognitive disability, epilepsy, cerebral palsy or autism" means that there is a causal relationship between the presence of an impairing condition and the developmental disability.

7. "Autism" means a condition characterized by severe disorders in communication and behavior resulting in limited ability to communicate, understand, learn and participate in social relationships.

8. "Behavioral-supported group home" means a community residential setting that meets all of the following:

(a) Is for not more than six persons with developmental disabilities.

(b) Is operated by a service provider under contract with the department.

(c) Provides room and board, daily habilitation, assistance in self-administering medication and medication administration and behavioral health services for clients with dual disorders, including psychiatric disorders and developmental disabilities, who engage in behaviors that are disruptive, socially inappropriate or harmful or dangerous to self or others, that interfere with functioning and quality of life or that may cause destruction of property.

9. "Case management" means coordinating the assistance needed by persons with developmental disabilities and their families in order to ensure that persons with developmental disabilities attain their maximum potential for independence, productivity and integration into the community.

10. "Case manager" means a person who coordinates the implementation of the individual program plan of goals, objectives and appropriate services for persons with developmental disabilities.

11. "Cerebral palsy" means a permanently disabling condition resulting from damage to the developing brain that may occur before, after or during birth and that results in loss or impairment of control over voluntary muscles.

12. "Child developmental certified home" means a regular foster home as defined in section 8-501 that is licensed pursuant to section 8-509 and that is certified by the department pursuant to section 36-593.01.

13. "Child developmental home" means a residential setting in a family home in which the care and supervision of the child are the responsibility, under a twenty-four-hour care model, of the licensee who serves as the developmental home provider of the child in the home setting and who, in that capacity, is not an employee of the division or of a service provider and the home provides the following services for a group of siblings or up to three children with developmental disabilities:

(a) Room and board.

(b) Habilitation.

(c) Appropriate personal care.

(d) Appropriate supervision.

14. "Client" means a person receiving developmental disabilities services from the department.

15. "Cognitive disability" means a condition that involves subaverage general intellectual functioning, that exists concurrently with deficits in adaptive behavior manifested before the age of eighteen and that is sometimes referred to as intellectual disability.

16. "Community residential setting":

(a) Means a residential setting in which persons with developmental disabilities live and are provided with appropriate supervision by the service provider responsible for operating the residential setting.

(b) Includes a child developmental home or an adult developmental home operated or contracted by the department or the department's contracted vendor, a group home operated or contracted by the department or a behavioral-supported group home or nursing-supported group home contracted by the department.

17. "Consent" means voluntary informed consent. Consent is voluntary if not given as the result of coercion or undue influence.  Consent is informed if the person giving the consent has been informed of and comprehends the nature, purpose, consequences, risks and benefits of the alternatives to the procedure, and has been informed and comprehends that withholding or withdrawing consent will not prejudice the future provision of care and services to the client. In cases of unusual or hazardous treatment procedures performed pursuant to section 36-561, subsection A, experimental research, organ transplantation and nontherapeutic surgery, consent is informed if, in addition to the foregoing, the person giving the consent has been informed of and comprehends the method to be used in the proposed procedure.

18. "Daily habilitation" means habilitation as defined in this section, except that the method of payment is for one unit per residential day.

19. "Department" means the department of economic security.

20. "Developmental disability" means either a strongly demonstrated potential that a child who is under six years of age has a developmental disability or will develop a developmental disability, as determined by a test performed pursuant to section 36-694 or by other appropriate tests, or a severe, chronic disability that:

(a) Is attributable to a cognitive disability, cerebral palsy, epilepsy, Down syndrome or autism.

(b) Is manifested before the age of eighteen.

(c) Is likely to continue indefinitely.

(d) Results in substantial functional limitations in three or more of the following areas of major life activity:

(i) Self-care.

(ii) Receptive and expressive language.

(iii) Learning.

(iv) Mobility.

(v) Self-direction.

(vi) Capacity for independent living.

(vii) Economic self-sufficiency.

(e) Reflects the need for a combination and sequence of individually planned or coordinated special, interdisciplinary or generic care, treatment or other services that are of lifelong or extended duration.

21. "Director" means the director of the department of economic security.

22. "Division" means the division of developmental disabilities in the department of economic security.

23. "Down syndrome" means a genetic disorder caused when abnormal cell division results in extra genetic material from chromosome 21, affecting a person's cognitive and physical abilities and causing developmental issues.

24. "Epilepsy" means a neurological condition characterized by abnormal electrical-chemical discharge in the brain. This discharge is manifested in various forms of physical activities called seizures.

25. "Group home":

(a) Means a community residential setting for not more than six persons with developmental disabilities that is operated by a service provider under contract with the department and that provides room and board and daily habilitation and other assessed medically necessary services and supports to meet the needs of each person.

(b) Does not include an adult developmental home, a child developmental home, a behavioral-supported group home, a nursing-supported group home or an intermediate care facility for individuals with intellectual disabilities.

26. "Guardian" means the person who, under court order, is appointed to fulfill the powers and duties prescribed in section 14-5312.  Guardian does not include a guardian pursuant to section 14-5312.01.

27. "Habilitation" means the process by which a person is assisted to acquire and maintain those life skills that enable the person to cope more effectively with personal and environmental demands and to raise the level of the person's physical, mental and social efficiency.

28. "Indigent" means a person with a developmental disability whose estate or parent is unable to bear the full cost of maintaining or providing services for that person in a developmental disabilities program.

29. "Individual program plan" means a written statement of services to be provided to a person with developmental disabilities, including habilitation goals and objectives, that is developed following initial placement evaluation and revised after periodic evaluations.

30. "Intermediate care facility for individuals with intellectual disabilities" means a facility that primarily provides health and rehabilitative services to persons with developmental disabilities that are above the service level of room and board or supervisory care services or personal care services as defined in section 36-401.

31. "Large group setting" means a setting that in addition to residential care provides support services such as therapy, recreation and transportation to seven or more persons with developmental disabilities who require intensive supervision.

32. "Least restrictive alternative" means an available program or facility that fosters independent living, that is the least confining for the client's condition and that provides service and treatment in the least intrusive manner reasonably and humanely appropriate to the individual's needs.

33. "Likely to continue indefinitely" means that the developmental disability has a reasonable likelihood of continuing for a protracted period of time or for life.

34. "Manifested before the age of eighteen" means that the disability must be apparent and have a substantially limiting effect on a person's functioning before the age of eighteen.

35. "Nursing-supported group home" has the same meaning prescribed in section 36-401.

36. "Physician" means a person who is licensed to practice pursuant to title 32, chapter 13 or 17.

37. "Placement evaluation" means an interview and evaluation of a person with a developmental disability and a review of the person's prior medical and program histories to determine the appropriate developmental disability programs and services for the person and recommendations for specific program placements for the person.

38. "Psychologist" means a person who is licensed pursuant to title 32, chapter 19.1.

39. "Respite services" means services that provide a short-term or long-term interval of rest or relief to the care provider of a person with a developmental disability.

40. "Responsible person" means the parent or guardian of a minor with a developmental disability, the guardian of an adult with a developmental disability or an adult with a developmental disability who is a client or an applicant for whom no guardian has been appointed.

41. "Service provider" means a person or agency that provides services to clients pursuant to a contract, service agreement or qualified vendor agreement with the division.

42. "State operated service center" means a state owned or leased facility that is operated by the department and that provides temporary residential care and space for child and adult services that include respite care, crisis intervention and diagnostic evaluation.

43. "Subaverage general intellectual functioning" means measured intelligence on standardized psychometric instruments of two or more standard deviations below the mean for the tests used.

44. "Substantial functional limitation" means a limitation so severe that extraordinary assistance from other people, programs, services or mechanical devices is required to assist the person in performing appropriate major life activities.

45. "Supervision" means the process by which the activities of an individual with developmental disabilities are directed, influenced or monitored.
A.R.S. § 36-2068 — Arizona Code / Title 36 / Chapter 18 / Article 4 / Section 2068
36-2068 Legal action; licensure; change of ownership; definitions
Status: in_force

36-2068. Legal action; licensure; change of ownership; definitions

A. The director may continue to pursue any court, administrative or enforcement action against a licensee even if the sober living home is in the process of being sold or transferred or has closed.

B. The department may revoke or suspend a sober living home license or deny an application for a sober living home license if:

1. The applicant, the licensee or a controlling person has a sober living home or health care institution license that is in an enforcement action or court action related to the health and safety of the residents or patients.

2. The department has determined for reasons other than those specified in paragraph 1 of this subsection that the issuance of a license is likely to jeopardize resident safety.

3. The applicant, the licensee or a controlling person has had in any state or jurisdiction an application or license to operate a sober living home or a health care institution denied, suspended or revoked, unless the denial was based on the failure to complete the licensing process or to pay a required licensing fee within the required time frame.

4. The applicant, the licensee or a controlling person has had in any state or jurisdiction a health professional license or certificate denied, suspended or revoked.

5. The applicant, the licensee or a controlling person provides false or misleading information to the department.

C. The department may deny the approval of a change in ownership of a currently licensed sober living home if the department determines that the transfer of ownership, whether involving a direct owner or indirect owner, may jeopardize resident safety.

D. For the purposes of this section:

1. "Controlling person" means a person who, with respect to a business organization:

(a) Has the power to vote at least ten percent of the outstanding voting securities of the business organization.

(b) If the business organization is a partnership, is a general partner or is a limited partner who holds at least ten percent of the voting rights of the partnership.

(c) If the business organization is a corporation, association or limited liability company, is the president, the chief executive officer, the incorporator, an agent or any person who owns or controls at least ten percent of the voting securities.

(d) Holds a beneficial interest in ten percent or more of the liabilities of the business organization.

2. "Direct owner" means a person that has an ownership or control interest in the sober living home totaling fifty-one percent or more.

3. "Indirect owner":

(a) Means a person that has an ownership or control interest in a direct owner totaling fifty-one percent or more.

(b) Includes an ownership or control interest in an indirect owner totaling fifty-one percent or more and a combination of direct ownership and indirect ownership or control interests totaling fifty-one percent or more in the sober living home.
A.R.S. § 36-2312 — Arizona Code / Title 36 / Chapter 23 / Article 2 / Section 2312
36-2312 Production of human embryo or human-animal hybrid; purchase or sale;
Status: in_force

36-2312. Production of human embryo or human-animal hybrid; purchase or sale; prohibitions; violation; classification; exemptions

A. A person shall not intentionally or knowingly create or attempt to create an in vitro human embryo by any means other than fertilization through the combining of a human egg with a human sperm.

B. A person shall not intentionally or knowingly:

1. Create or attempt to create a human-animal hybrid.

2. Transfer or attempt to transfer a human embryo into a nonhuman womb.

3. Transfer or attempt to transfer a nonhuman embryo into a human womb.

4. Transport or receive for any purpose a human-animal hybrid.

C. A person shall not purchase or sell or offer to purchase or sell an in vitro human embryo and shall not advertise for the purchase or sale of an in vitro human embryo.  This subsection does not prohibit payment to a physician by a patient or on a patient's behalf for otherwise lawful services to treat infertility.

D. A person who violates this section is guilty of a class 1 misdemeanor.

E. This section does not prohibit either of the following if the activity does not violate subsection B or meet the definition of human-animal hybrid:

1. Research involving the use of transgenic animal models containing human genes.

2. Xenotransplantation of human organs, tissues or cells into recipient animals other than animal embryos.
A.R.S. § 36-327 — Arizona Code / Title 36 / Chapter 3 / Article 3 / Section 327
36-327 Disinterment-reinterment permit
Status: in_force

36-327. Disinterment-reinterment permit

A. Except as otherwise provided by law, a disinterment-reinterment permit is required before a person disinters human remains.  The state registrar shall provide a permit to disinter human remains either by a court order issued in this state or by the written consent of the decedent's family member who has the highest priority.  The order of priority is the same as provided in section 36-831.

B. A disinterment-reinterment permit is not required if disinterment and reinterment occur in the same cemetery for ordinary relocation or for reasons of internal management of the cemetery.
A.R.S. § 36-525 — Arizona Code / Title 36 / Chapter 5 / Article 4 / Section 525
36-525 Apprehension and transportation by peace and police officers; immunity
Status: in_force

36-525. Apprehension and transportation by peace and police officers; immunity

A. 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 others, and if 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. 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.

B. A police officer who is an employee of the United States department of veterans affairs may take into custody and transport to a screening agency or an evaluation agency, as applicable, a person who is a veteran of the United States armed forces, consistent with subsection A of this section.

C. If apprehension takes place on or about the premises of the apprehended person, the peace officer or the police officer who is an employee of the United States department of veterans affairs shall take reasonable precautions to safeguard the premises and the property on the premises, unless the property and premises are in the possession of a responsible relative or guardian.

D. A peace officer or a police officer who is an employee of the United States department of veterans affairs who makes a good faith effort to follow the requirements of this section is not subject to civil liability.
A.R.S. § 36-202.01 — Arizona Code / Title 36 / Chapter 2 / Article 1 / Section 202.01
36-202.01 Admission of juveniles to state hospital
Status: in_force

36-202.01. Admission of juveniles to state hospital

The Arizona state hospital shall collect census data for juvenile treatment programs to establish maximum capacity and the allocation formula required pursuant to section 36-206, subsection D. The Arizona state hospital is not required to provide services to juveniles that exceed the funded capacity. If the Arizona state hospital reaches its funded capacity for juveniles, the superintendent of the state hospital shall establish a waiting list for admission based on the date of the commitment or treatment order.
A.R.S. § 36-254 — Arizona Code / Title 36 / Chapter 2 / Article 2 / Section 254
36-254 Evidentiary effect of certificate of chief of state laboratory
Status: in_force

36-254. Evidentiary effect of certificate of chief of state laboratory

A certificate of analysis and examination by the chief of the state laboratory is prima facie evidence of the facts therein stated.
A.R.S. § 36-136 — Arizona Code / Title 36 / Chapter 1 / Article 2 / Section 136
36-136 Powers and duties of director; compensation of personnel; rules; definitions
Status: in_force

36-136. Powers and duties of director; compensation of personnel; rules; definitions

A. The director shall:

1. Be the executive officer of the department of health services and the state registrar of vital statistics but shall not receive compensation for services as registrar.

2. Perform all duties necessary to carry out the functions and responsibilities of the department.

3. Prescribe the organization of the department. The director shall appoint or remove personnel as necessary for the efficient work of the department and shall prescribe the duties of all personnel. The director may abolish any office or position in the department that the director believes is unnecessary.

4. Administer and enforce the laws relating to health and sanitation and the rules of the department.

5. Provide for the examination of any premises if the director has reasonable cause to believe that on the premises there exists a violation of any health law or rule of this state.

6. Exercise general supervision over all matters relating to sanitation and health throughout this state. When in the opinion of the director it is necessary or advisable, a sanitary survey of the whole or of any part of this state shall be made. The director may enter, examine and survey any source and means of water supply, sewage disposal plant, sewerage system, prison, public or private place of detention, asylum, hospital, school, public building, private institution, factory, workshop, tenement, public washroom, public restroom, public toilet and toilet facility, public eating room and restaurant, dairy, milk plant or food manufacturing or processing plant, and any premises in which the director has reason to believe there exists a violation of any health law or rule of this state that the director has the duty to administer.

7. Prepare sanitary and public health rules.

8. Perform other duties prescribed by law.

B. If the director has reasonable cause to believe that there exists a violation of any health law or rule of this state, the director may inspect any person or property in transportation through this state, and any car, boat, train, trailer, airplane or other vehicle in which that person or property is transported, and may enforce detention or disinfection as reasonably necessary for the public health if there exists a violation of any health law or rule.

C. The director, after consultation with the department of administration, may take all necessary steps to enhance the highest and best use of the state hospital property, including contracting with third parties to provide services, entering into short-term lease agreements with third parties to occupy or renovate existing buildings and entering into long-term lease agreements to develop the land and buildings. The director shall deposit any monies collected from contracts and lease agreements entered into pursuant to this subsection in the Arizona state hospital charitable trust fund established by section 36-218. At least thirty days before issuing a request for proposals pursuant to this subsection, the department of health services shall hold a public hearing to receive community and provider input regarding the highest and best use of the state hospital property related to the request for proposals. The department shall report to the joint committee on capital review on the terms, conditions and purpose of any lease or sublease agreement entered into pursuant to this subsection relating to state hospital lands or buildings or the disposition of real property pursuant to this subsection, including state hospital lands or buildings, and the fiscal impact on the department and any revenues generated by the agreement. Any lease or sublease agreement entered into pursuant to this subsection relating to state hospital lands or buildings or the disposition of real property pursuant to this subsection, including state hospital lands or buildings, must be reviewed by the joint committee on capital review.

D. The director may deputize, in writing, any qualified officer or employee in the department to do or perform on the director's behalf any act the director is by law empowered to do or charged with the responsibility of doing.

E. The director may delegate to a local health department, county environmental department or public health services district any functions, powers or duties that the director believes can be competently, efficiently and properly performed by the local health department, county environmental department or public health services district if:

1. The director or superintendent of the local health department, environmental department or public health services district is willing to accept the delegation and agrees to perform or exercise the functions, powers and duties conferred in accordance with the standards of performance established by the director of the department of health services.

2. Monies appropriated or otherwise made available to the department for distribution to or division among counties or public health services districts for local health work may be allocated or reallocated in a manner designed to ensure the accomplishment of recognized local public health activities and delegated functions, powers and duties in accordance with applicable standards of performance. If in the director's opinion there is cause, the director may terminate all or a part of any delegation and may reallocate all or a part of any monies that may have been conditioned on the further performance of the functions, powers or duties conferred.

F. The compensation of all personnel shall be as determined pursuant to section 38-611.

G. The director may make and amend rules necessary for the proper administration and enforcement of the laws relating to the public health.

H. Notwithstanding subsection I, paragraph 1 of this section, the director may define and prescribe emergency measures for detecting, reporting, preventing and controlling communicable or infectious diseases or conditions if the director has reasonable cause to believe that a serious threat to public health and welfare exists. Emergency measures are effective for not longer than eighteen months.

I. The director, by rule, shall:

1. Define and prescribe reasonably necessary measures for detecting, reporting, preventing and controlling communicable and preventable diseases. The rules shall declare certain diseases that are reportable. The rules shall prescribe measures, including isolation or quarantine, that are reasonably required to prevent the occurrence of, or to seek early detection and alleviation of, disability, insofar as possible, from communicable or preventable diseases. The rules shall include reasonably necessary measures to control animal diseases that are transmittable to humans.

2. Define and prescribe reasonably necessary measures, in addition to those prescribed by law, regarding the preparation, embalming, cremation, interment, disinterment and transportation of dead human bodies and the conduct of funerals, relating to and restricted to communicable diseases and regarding the removal, transportation, cremation, interment or disinterment of any dead human body.

3. Define and prescribe reasonably necessary procedures that are not inconsistent with law in regard to the use and accessibility of vital records, delayed birth registration and the completion, change and amendment of vital records.

4. Except as relating to the beneficial use of wildlife meat by public institutions and charitable organizations pursuant to title 17, prescribe reasonably necessary measures to ensure that all food or drink, including meat and meat products and milk and milk products sold at the retail level, provided for human consumption is free from unwholesome, poisonous or other foreign substances and filth, insects or disease-causing organisms. The rules shall prescribe reasonably necessary measures governing the production, processing, labeling, storing, handling, serving and transportation of these products. The rules shall prescribe minimum standards for the sanitary facilities and conditions that shall be maintained in any warehouse, restaurant or other premises, except a meatpacking plant, slaughterhouse, wholesale meat processing plant, dairy product manufacturing plant or trade product manufacturing plant. The rules shall prescribe minimum standards for any truck or other vehicle in which food or drink is produced, processed, stored, handled, served or transported. The rules shall provide for the inspection and licensing of premises and vehicles so used, and for abatement as public nuisances of any premises or vehicles that do not comply with the rules and minimum standards. The rules shall provide an exemption relating to food or drink that is:

(a) Served at a noncommercial social event such as a potluck.

(b) Prepared at a cooking school that is conducted in an owner-occupied home.

(c) Not potentially hazardous and prepared in a kitchen of a private home for sale or distribution for noncommercial purposes.

(d) Prepared or served at an employee-conducted function that lasts less than four hours and is not regularly scheduled, such as an employee recognition, an employee fundraising or an employee social event.

(e) Offered at a child care facility and limited to commercially prepackaged food that is not potentially hazardous and whole fruits and vegetables that are washed and cut on-site for immediate consumption.

(f) Offered at locations that sell only commercially prepackaged food or drink that is not potentially hazardous.

(g) A cottage food product that is prepared in a kitchen of a private home for commercial purposes consistent with chapter 8, article 2 of this title.

(h) A whole fruit or vegetable grown in a public school garden that is washed and cut on-site for immediate consumption.

(i) Produce in a packing or holding facility that is subject to the United States food and drug administration produce safety rule (21 Code of Federal Regulations part 112) as administered by the Arizona department of agriculture pursuant to title 3, chapter 3, article 4.1. For the purposes of this subdivision, "holding", "packing" and "produce" have the same meanings prescribed in section 3-525.

(j) Spirituous liquor produced on the premises licensed by the department of liquor licenses and control. This exemption includes both of the following:

(i) The area in which production and manufacturing of spirituous liquor occurs, as defined in an active basic permit on file with the United States alcohol and tobacco tax and trade bureau.

(ii) The area licensed by the department of liquor licenses and control as a microbrewery, farm winery or craft distiller that is open to the public and serves spirituous liquor and commercially prepackaged food, crackers or pretzels for consumption on the premises. A producer of spirituous liquor may not provide, allow or expose for common use any cup, glass or other receptacle used for drinking purposes. For the purposes of this item, "common use" means the use of a drinking receptacle for drinking purposes by or for more than one person without the receptacle being thoroughly cleansed and sanitized between consecutive uses by methods prescribed by or acceptable to the department.

(k) Spirituous liquor produced by a producer that is licensed by the department of liquor licenses and control or spirituous liquor imported and sold by wholesalers that is licensed by the department of liquor licenses and control. This exemption includes all commercially prepackaged spirituous liquor and all spirituous liquor poured at a licensed special event, festival or fair in this state.

5. Prescribe reasonably necessary measures to ensure that all meat and meat products for human consumption handled at the retail level are delivered in a manner and from sources approved by the Arizona department of agriculture and are free from unwholesome, poisonous or other foreign substances and filth, insects or disease-causing organisms. The rules shall prescribe standards for sanitary facilities to be used in identifying, storing, handling and selling all meat and meat products sold at the retail level.

6. Prescribe reasonably necessary measures regarding production, processing, labeling, handling, serving and transportation of bottled water to ensure that all bottled drinking water distributed for human consumption is free from unwholesome, poisonous, deleterious or other foreign substances and filth or disease-causing organisms. The rules shall prescribe minimum standards for the sanitary facilities and conditions that shall be maintained at any source of water, bottling plant and truck or vehicle in which bottled water is produced, processed, stored or transported and shall provide for inspection and certification of bottled drinking water sources, plants, processes and transportation and for abatement as a public nuisance of any water supply, label, premises, equipment, process or vehicle that does not comply with the minimum standards. The rules shall prescribe minimum standards for bacteriological, physical and chemical quality for bottled water and for submitting samples at intervals prescribed in the standards.

7. Define and prescribe reasonably necessary measures governing ice production, handling, storing and distribution to ensure that all ice sold or distributed for human consumption or for preserving or storing food for human consumption is free from unwholesome, poisonous, deleterious or other foreign substances and filth or disease-causing organisms. The rules shall prescribe minimum standards for the sanitary facilities and conditions and the quality of ice that shall be maintained at any ice plant, storage and truck or vehicle in which ice is produced, stored, handled or transported and shall provide for inspection and licensing of the premises and vehicles, and for abatement as public nuisances of ice, premises, equipment, processes or vehicles that do not comply with the minimum standards.

8. Define and prescribe reasonably necessary measures concerning sewage and excreta disposal, garbage and trash collection, storage and disposal, and water supply for recreational and summer camps, campgrounds, motels, tourist courts, trailer coach parks and hotels. The rules shall prescribe minimum standards for preparing food in community kitchens, adequacy of excreta disposal, garbage and trash collection, storage and disposal and water supply for recreational and summer camps, campgrounds, motels, tourist courts, trailer coach parks and hotels and shall provide for inspection of these premises and for abatement as public nuisances of any premises or facilities that do not comply with the rules. Primitive camp and picnic grounds offered by this state or a political subdivision of this state are exempt from rules adopted pursuant to this paragraph but are subject to approval by a county health department under sanitary regulations adopted pursuant to section 36-183.02. Rules adopted pursuant to this paragraph do not apply to two or fewer recreational vehicles as defined in section 33-2102 that are not park models or park trailers, that are parked on owner-occupied residential property for less than sixty days and for which no rent or other compensation is paid. For the purposes of this paragraph, "primitive camp and picnic grounds" means camp and picnic grounds that are remote in nature and without accessibility to public infrastructure such as water, electricity and sewer.

9. Define and prescribe reasonably necessary measures concerning the sewage and excreta disposal, garbage and trash collection, storage and disposal, water supply and food preparation of all public schools. The rules shall prescribe minimum standards for sanitary conditions that shall be maintained in any public school and shall provide for inspection of these premises and facilities and for abatement as public nuisances of any premises that do not comply with the minimum standards.

10. Prescribe reasonably necessary measures to prevent pollution of water used in public or semipublic swimming pools and bathing places and to prevent deleterious health conditions at these places. The rules shall prescribe minimum standards for sanitary conditions that shall be maintained at any public or semipublic swimming pool or bathing place and shall provide for inspection of these premises and for abatement as public nuisances of any premises and facilities that do not comply with the minimum standards. The rules shall be developed in cooperation with the director of the department of environmental quality and shall be consistent with the rules adopted by the director of the department of environmental quality pursuant to section 49-104, subsection B, paragraph 12.

11. Prescribe reasonably necessary measures to keep confidential information relating to diagnostic findings and treatment of patients, as well as information relating to contacts, suspects and associates of communicable disease patients.  Confidential information may not be made available for political or commercial purposes.

12. Prescribe reasonably necessary measures regarding human immunodeficiency virus testing as a means to control the transmission of that virus, including the designation of anonymous test sites as dictated by current epidemiologic and scientific evidence.

13. Establish an online registry of food preparers that are authorized to prepare cottage food products for commercial purposes pursuant to paragraph 4 of this subsection and chapter 8, article 2 of this title. A registered food preparer shall renew the registration every three years and shall provide to the department updated registration information within thirty days after any change.

14. Prescribe an exclusion for fetal demise cases from the standardized survey known as "the hospital consumer assessment of healthcare providers and systems".

J. The rules adopted under the authority conferred by this section shall be observed throughout this state and shall be enforced by each local board of health or public health services district, but this section does not limit the right of any local board of health or county board of supervisors to adopt ordinances and rules as authorized by law within its jurisdiction if the ordinances and rules do not conflict with state law and are equal to or more restrictive than the rules of the director.

K. The powers and duties prescribed by this section do not apply in instances in which regulatory powers and duties relating to public health are vested by the legislature in any other state board, commission, agency or instrumentality, except that with regard to the regulation of meat and meat products, the department of health services and the Arizona department of agriculture within the area delegated to each shall adopt rules that are not in conflict.

L. The director, in establishing fees authorized by this section, shall comply with title 41, chapter 6. The department shall not set a fee at more than the department's cost of providing the service for which the fee is charged. State agencies are exempt from all fees imposed pursuant to this section.

M. After consultation with the state superintendent of public instruction, the director shall prescribe the criteria the department shall use in deciding whether or not to notify a local school district that a pupil in the district has tested positive for the human immunodeficiency virus antibody. The director shall prescribe the procedure by which the department shall notify a school district if, pursuant to these criteria, the department determines that notification is warranted in a particular situation. This procedure shall include a requirement that before notification the department shall determine to its satisfaction that the district has an appropriate policy relating to nondiscrimination of the infected pupil and confidentiality of test results and that proper educational counseling has been or will be provided to staff and pupils.

N. Until the department adopts exemptions by rule as required by subsection I, paragraph 4, subdivision (f) of this section, food and drink are exempt from the rules prescribed in subsection I of this section if offered at locations that sell only commercially prepackaged food or drink that is not potentially hazardous, without a limitation on its display area.

O. Until the department adopts exemptions by rule as required by subsection I, paragraph 4, subdivision (h) of this section, a whole fruit or vegetable grown in a public school garden that is washed and cut on-site for immediate consumption is exempt from the rules prescribed in subsection I of this section.

P. Until the department adopts an exclusion by rule as required by subsection I, paragraph 14 of this section, the standardized survey known as "the hospital consumer assessment of healthcare providers and systems" may not include patients who experience a fetal demise.

Q. Until the department adopts exemptions by rule as required by subsection I, paragraph 4, subdivision (j) of this section, spirituous liquor and commercially prepackaged food, crackers or pretzels that meet the requirements of subsection I, paragraph 4, subdivision (j) of this section are exempt from the rules prescribed in subsection I of this section.

R. For the purposes of this section:

1. "Cottage food product" has the same meaning prescribed in section 36-931.

2. "Fetal demise" means a fetal death that occurs or is confirmed in a licensed hospital. Fetal demise does not include an abortion as defined in section 36-2151.
A.R.S. § 36-1634 — Arizona Code / Title 36 / Chapter 13 / Article 2.1 / Section 1634
36-1634 Violation; classification
Status: in_force

36-1634. Violation; classification

Any person who knowingly violates any provision of this article is guilty of a class 2 misdemeanor.
A.R.S. § 36-191 — Arizona Code / Title 36 / Chapter 1 / Article 4 / Section 191
36-191 Violation; classification
Status: in_force

36-191. Violation; classification

A person violating any provision of this article or the rules and regulations adopted thereunder is guilty of a class 3 misdemeanor.
A.R.S. § 36-514 — Arizona Code / Title 36 / Chapter 5 / Article 2 / Section 514
36-514 Visitation; telephone; correspondence; religious freedom; legal residence
Status: in_force

36-514. Visitation; telephone; correspondence; religious freedom; legal residence

A. Every person who is detained for evaluation or treatment pursuant to this chapter shall have the following additional rights:

1. To be visited by the person's personal physician or other health care professional, guardian, agent appointed pursuant to chapter 32 of this title, attorney and clergyman or any other person, subject to reasonable limitations as the individual in charge of the agency may direct.

2. To have reasonable access to telephones between the hours of 9:00 a.m. and 9:00 p.m. to make and receive confidential calls. In addition, a person who is confined pursuant to this title is allowed to make two completed local telephone calls within two hours after initial confinement. Long-distance calls are allowed if the patient can pay the agency for them or can properly charge them to another number. The agency may restrict the telephone privileges of a patient if it is notified by the person receiving the calls that the person is being harassed by the calls and wishes them curtailed or halted. Restriction of telephone privileges shall be entered into the patient's clinical record and the information in the record shall be made available on request to the person and that person's attorney, guardian or agent appointed pursuant to chapter 32 of this title.

3. To be furnished with reasonable amounts of stationery and postage and to be allowed to correspond by mail without censorship with any person.

4. To enjoy religious freedom and the right to continue the practice of the person's religion in accordance with its tenets during the detainment, except that this right may not interfere with the operation of the agency.

B. Court-ordered evaluation or treatment pursuant to this chapter does not operate to change the legal residence of a patient.
A.R.S. § 36-2403 — Arizona Code / Title 36 / Chapter 25 / Article 1 / Section 2403
36-2403 Confidentiality; protection from discovery proceedings and subpoena; exceptions
Status: in_force

36-2403. Confidentiality; protection from discovery proceedings and subpoena; exceptions

A. Quality assurance information shall be confidential and is not subject to subpoena or order to produce except in proceedings before the appropriate state licensing or certifying agency, or in actions by a licensed health care provider against a health care entity arising from the discipline of the licensed health care provider or the refusal, termination, suspension or limitation of privileges.  A health care entity or a person who provides or receives information or who participates in, takes any action in or makes any decision or recommendation for or in the course of quality assurance activities may not be subpoenaed to testify in any judicial or quasi-judicial proceeding relating to the subject matter of the quality assurance activities.

B. This article shall not be construed to affect any patient's claim to privilege or privacy or to prevent the subpoena of a patient's health care records if they are otherwise subject to discovery.  In any legal action brought pursuant to section 36-2402 in which it is alleged that quality assurance activities were inadequate or were negligently conducted, representatives of a health care entity are permitted to testify only as to whether there were quality assurance activities relating to the subject matter being litigated and the date or dates of the quality assurance activities.

C. Sharing of information about quality assurance activities in accordance with section 36-2402 does not waive or otherwise impair the confidentiality of the information shared. Governing bodies and administrative and other personnel of a health care entity may participate in quality assurance activities without waiving confidentiality. All individuals or entities sharing or receiving quality assurance information shall maintain the information confidentially in accordance with this section.

D. A state agency or the affected licensed health care provider receiving or reviewing quality assurance information pursuant to section 36-2402 shall maintain the information confidentially, and such entities and individuals are subject to the same provisions concerning discovery and use in legal actions as are health care entities.

E. Except as otherwise provided in this subsection, information that is otherwise discoverable does not become confidential based solely on its submission to or consideration by a health care entity conducting confidential quality assurance activities.  A health care entity conducting quality assurance activities may not produce such information if discovery of such information might reveal the deliberative process engaged in during such quality assurance activities.

F. This section does not apply to information considered confidential under section 36-2917.
A.R.S. § 36-530 — Arizona Code / Title 36 / Chapter 5 / Article 4 / Section 530
36-530 Evaluation and treatment
Status: in_force

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 the person's condition for the full period that the person is hospitalized. A clinical record shall be kept for each person 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 remain in the facility during the evaluation, which shall be completed in less than seventy-two hours. Unless the person is released or admitted on a voluntary basis, the filing of the petition for court-ordered treatment shall be completed within seventy-two hours, excluding weekends and holidays.

C. A person being evaluated on an outpatient basis will not remain in the facility overnight but will be examined during the usual outpatient working hours of the facility on a schedule of appointments. The evaluation will 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 taken into custody for evaluation on an inpatient basis.

E. In the course of conducting an evaluation, the evaluation agency shall solicit, accept and consider information relevant to the present behavior and past behavioral health history of the proposed patient from persons known to the agency who have a significant relationship with the proposed patient, including family members and guardians.
A.R.S. § 36-418.01 — Arizona Code / Title 36 / Chapter 4 / Article 1 / Section 418.01
36-418.01 Behavioral health facilities; dependent children; placement; report; definition
Status: in_force

36-418.01. Behavioral health facilities; dependent children; placement; report; definition

A. If a foster child who is in the care, custody and control of the department of child safety is approved for placement in a behavioral health facility licensed pursuant to this chapter, the behavioral health facility may not deny or refuse placement of the foster child if, subject to the availability of a bed or space in the behavioral health facility, all of the following apply:

1. The foster child's behavioral needs are within the scope of services.

2. The foster child's placement in the behavioral health facility is clinically appropriate.

3. The foster child's placement in the behavioral health facility does not disrupt the environment of the behavioral health facility, including the behaviors and needs of other residents of the behavioral health facility.

4. The foster child's primary condition is a behavioral health condition.

B. If a behavioral health facility denies or refuses placement of the foster child pursuant to subsection A of this section, the behavioral health facility shall do both of the following:

1. Document the specific clinical reason for denying or refusing placement of the foster child.

2. Within twenty-four hours after denying or refusing placement of the foster child, notify the placement agency that the behavioral health facility's denial or refusal is necessary.

C. When possible, a behavioral health facility that denies or refuses placement of a foster child shall work collaboratively with the placement agency to explore alternative placements or additional supports for the foster child that may facilitate a successful placement of the foster child.  The behavioral health facility shall document efforts made with the placement facility for successful placement of the foster child.

D. A behavioral health facility may not deny the placement of a foster child who requires medication management for a chronic physical health condition.

E. For the purposes of this section, "placement agency" means the department of child safety or any other agency that is authorized to approve a foster child for placement in a behavioral health facility or program.
A.R.S. § 36-601 — Arizona Code / Title 36 / Chapter 6 / Article 1 / Section 601
36-601 Public nuisances dangerous to public health
Status: in_force

36-601. Public nuisances dangerous to public health

A. The following conditions are specifically declared public nuisances dangerous to the public health:

1. Any condition or place in populous areas that constitutes a breeding place for flies, rodents, mosquitoes and other insects that are capable of carrying and transmitting disease-causing organisms to any person or persons or any condition or place that constitutes a feral colony of honeybees that is not currently maintained by a beekeeper and that poses a health or safety hazard to the public.

2. Any spoiled or contaminated food or drink intended for human consumption.

3. Any restaurant, food market, bakery or other place of business or any vehicle where food is prepared, packed, processed, stored, transported, sold or served to the public that is not constantly maintained in a sanitary condition.

4. Any place, condition or building that is controlled or operated by any governmental agency and that is not maintained in a sanitary condition.

5. All sewage, human excreta, wastewater, garbage or other organic wastes deposited, stored, discharged or exposed so as to be a potential instrument or medium in the transmission of disease to or between any person or persons.

6. Any vehicle or container that is used in the transportation of garbage, human excreta or other organic material and that is defective and allows leakage or spillage of contents.

7. The presence of ectoparasites such as bedbugs, lice, mites and others in any place where sleeping accommodations are offered to the public.

8. The maintenance of any overflowing septic tank or cesspool, the contents of which may be accessible to flies.

9. The pollution or contamination of any domestic waters.

10. The use of the so-called common drinking cup used for drinking purposes by more than one person.  This paragraph does not apply to receptacles properly washed and sanitized after each service.

11. The presence of common towels for use of the public in any public or semipublic place unless properly washed and sanitized following each use.

12. Buildings or any parts of buildings that are in a filthy condition and that may endanger the health of persons living in the vicinity.

13. Spitting or urinating on sidewalks, or floors or walls of a public building or buildings used for public assemblage, or a building used for manufacturing or industrial purposes, or on the floors or platforms or any part of a railroad or other public conveyance.

14. The use of the contents of privies, cesspools or septic tanks or the use of sewage or sewage plant effluents for fertilizing or irrigation purposes for crops or gardens except by specific approval of the department of health services or the department of environmental quality.

15. The maintenance of public assemblage or places of assemblage without providing adequate sanitary facilities.  Open surface privies are adequate sanitary facilities if they are outside populous areas and meet reasonable health requirements.

16. Hotels, tourist courts and other lodging establishments that are not kept in a clean and sanitary condition or for which suitable and adequate toilet facilities are not provided.

17. The storage, collection, transportation, disposal and reclamation of garbage, trash, rubbish, manure and other objectionable wastes other than as provided and authorized by law.

18. Water, other than that used by irrigation, industrial or similar systems for nonpotable purposes, that is sold to the public, distributed to the public or used in production, processing, storing, handling, servicing or transportation of food and drink and that is unwholesome, poisonous or contains deleterious or foreign substances or filth or disease causing substances or organisms.

19. The emission of mercaptan in a concentration level that causes endangerment to the health or safety of any considerable number of persons of a neighborhood or community.

20. The operation of an environmental laboratory in violation of chapter 4.3, article 1 of this title.

B. If the director has reasonable cause to believe from information furnished to the director or from investigation made by the director that any person is maintaining a nuisance or engaging in any practice contrary to the health laws of this state, the director shall promptly serve on that person by certified mail a cease and desist order requiring the person, on receipt of the order, promptly to cease and desist from that act. Within fifteen days after receipt of the order, the person to whom it is directed may request the director to hold a hearing. The director, as soon as practicable, shall hold a hearing, and if the director determines the order is reasonable and just and that the practice engaged in is contrary to the health laws of this state, the director shall order the person to comply with the cease and desist order.

C. If a person fails or refuses to comply with the order of the director, or if a person to whom the order is directed does not request a hearing and fails or refuses to comply with the cease and desist order served by mail under subsection B, the director may file an action in the superior court in the county in which a violation occurred, restraining and enjoining the person from engaging in further acts. The court shall proceed as in other actions for injunctions.

D. Notwithstanding subsection A, paragraph 19, the emission of mercaptan as a by-product of a pesticide is not a nuisance if applied according to state and federal restrictions.

E. Notwithstanding subsection A, paragraph 3, a restaurant that uses sawdust on the floors of its dining areas is not in violation of this section or local health department sanitary rules if the restaurant replaces the sawdust each day with clean sawdust and complies with applicable standards for fire safety.
A.R.S. § 36-3294 — Arizona Code / Title 36 / Chapter 32 / Article 7 / Section 3294
36-3294 Registration
Status: in_force

36-3294. Registration

A. The qualifying health information exchange organization shall establish a process to allow persons to submit documents described in section 36-3292 to the health care directives registry. The qualifying health information exchange organization shall adopt industry standard safeguards to ensure the security, privacy and integrity of the documents submitted to and maintained in the health care directives registry.

B. The qualifying health information exchange organization is not required to review a document to ensure that it complies with the particular statutory requirements applicable to the document.

C. The qualifying health information exchange organization shall provide a person who submitted the document to the health care directives registry with a viewable record of the information entered into the registry and allow the person to submit corrected information.

D. The qualifying health information exchange organization shall activate the entry of a submitted document into the health care directives registry only after receiving confirmation that the information submitted is correct.

E. The qualifying health information exchange organization shall establish a process to allow persons who submit documents to the health care directives registry to review, retrieve, revoke and replace the documents.

F. The qualifying health information exchange organization shall establish a process for removing or distinguishing documents that have been revoked or replaced by more recent documents.

G. The entry of a document pursuant to this article does not:

1. Affect the validity of the document.

2. Relate to the accuracy of information contained in the document.

3. Create a presumption regarding the validity of the document or the accuracy of information contained in the document.
A.R.S. § 36-2915 — Arizona Code / Title 36 / Chapter 29 / Article 1 / Section 2915
36-2915 Lien of administration on damages recovered by injured person; perfection, recording, assignment and notice of lien
Status: in_force

36-2915. Lien of administration on damages recovered by injured person; perfection, recording, assignment and notice of lien

A. The administration is entitled to a lien for the charges for hospital or medical care and treatment of an injured person for which the administration or a contractor is responsible, on any and all claims of liability or indemnity for damages accruing to the person to whom hospital or medical service is rendered, or to the legal representative of such person, on account of injuries giving rise to such claims and which necessitated such hospital or medical care and treatment.  The member or the member's legal representative must provide written notice to the administration within twenty calendar days after the commencement of a civil action or other proceeding to establish the liability of any third party or to collect monies payable from accident insurance, liability insurance, workers' compensation, health insurance, medical payment insurance, underinsured coverage, uninsured coverage or any other first or third party source.

B. In order to perfect a lien granted by this section, the director or the director's authorized representative, before or within sixty days from the date of notification to the administration of the hospital discharge or rendering of medical care and treatment, shall record in the office of the recorder of the county in which the injuries were incurred a verified statement in writing setting forth the name and address of the patient as they appear on the records of the administration, the name and address of the administration, the dates of admission to and discharge of the patient from the hospital or the dates on which medical care and treatment were provided to the patient, the amount estimated to be due for hospital or medical care and treatment, and, to the best of the director's knowledge, the names and addresses of all persons, firms or corporations and their insurance carriers alleged by the injured person or that person's legal representative to be liable for damages arising from the injuries for which he was hospitalized or for which medical care and treatment were provided.  However, the director or the director's authorized representative is not required to include the address of the patient in the verified statement if the administration's records indicate that the patient's injuries may have resulted from an offense against the patient as defined in section 13-105.  The director or the director's authorized representative, within five days after recording the lien, shall mail a copy of the lien, postage prepaid, to the patient and to each person, firm or corporation, including insurance carriers, alleged to be liable for liability or indemnity damages, at the address given in the statement. The recording of the lien is notice of the lien to all persons, firms or corporations, including insurance carriers, liable for liability or indemnity damages, whether or not they are named in the lien.

C. The recorder shall endorse on a lien recorded as provided by this section the date and hour of receipt and such facts as are necessary to indicate that it has been recorded.

D. The lien may be assigned in whole or in part to a contractor that is responsible for hospital or medical services.

E. The director shall establish by rule procedures for a contractor and a noncontracting provider to notify the administration concerning the delivery of hospital or medical services to a person who may have claims for damages.

F. Notwithstanding any other law, a lien or claim provided for by this article has priority over a lien of the department pursuant to section 36-596.01, a lien of the counties pursuant to section 11-291, a health care provider lien pursuant to title 33, chapter 7, article 3 and a claim against a third party payor.  A lien of the department of economic security pursuant to section 36-596.01, a lien of a special health care district pursuant to section 48-5541.01, subsection N and a lien of the counties pursuant to section 11-291 has priority over a health care provider lien pursuant to title 33, chapter 7, article 3 and a claim against a third party payor.

G. A lien authorized pursuant to this chapter may be amended to reflect current charges.  However, if the administration is given notice of an impending settlement of the member's claim at least fifteen working days before the final settlement of that claim, the lien may not be amended after the time of final settlement.

H. A public entity shall compromise a claim it has pursuant to this section or section 11-291, 12-962, 36-596, 36-596.01, 36-2903, 36-2935 or 36-2956 if, after considering the factors listed in subsection I of this section, the compromise provides a settlement of the claim that is fair and equitable.

I. In determining the extent of the compromise of the claim required by subsection H of this section, the public entity shall consider the following factors:

1. The nature and extent of the patient's injury or illness.

2. The sufficiency of insurance or other sources of indemnity available to the patient.

3. Any other factor relevant for a fair and equitable settlement under the circumstances of a particular case.

J. Notwithstanding any other law, for the purpose of recovering monies from third party payors as provided by this section, a lien that includes a cover sheet pursuant to subsection K of this section and that is filed by an entity under contract with the administration, a health plan or a program contractor, or the authorized representatives of these entities, is considered filed by the state for the purposes of payment of county recorder fees pursuant to section 11-475, subsection A, paragraph 2.

K. A health plan, a program contractor, an entity under contract with the administration or an authorized representative of the health plan, program contractor or entity shall include a cover sheet, as prescribed by the administration, when filing a lien on behalf of the administration pursuant to this section. The cover sheet shall be signed by the director on the administration's letterhead with the statutory authority of the health plan, program contractor, entity or authorized representative of the health plan, program contractor or entity to file a lien on behalf of the administration.
A.R.S. § 36-541 — Arizona Code / Title 36 / Chapter 5 / Article 5 / Section 541
36-541 Mandatory local treatment; placement at state hospital
Status: in_force

36-541. Mandatory local treatment; placement at state hospital

A. A patient who is ordered by a court to undergo treatment and who is not hospitalized in the state hospital at the time of the order shall undergo treatment for at least twenty-five days in a local mental health treatment agency that is geographically convenient for the patient before being hospitalized in the state hospital. This section does not apply if the court finds, at a hearing on court-ordered treatment, that the patient's present condition and history demonstrate that the patient will not benefit from the required period of treatment in a local mental health treatment agency or that the state hospital provides a program that is specific to the needs of the patient and is unavailable in the local mental health treatment agency, or when there is no local mental health treatment agency readily available to the patient. Such a finding shall be based at least on the annual written description by the state hospital of programs and services available and appropriate written reports from the medical director of the local mental health treatment agency. The patient may be immediately hospitalized at the state hospital whenever the court determines that this section does not apply.

B. A patient who is ordered by a court to undergo treatment may be admitted for treatment if the patient is accepted by the superintendent of the state hospital for treatment at the state hospital or if the court orders placement at the state hospital pursuant to subsection A or C of this section.

C. During any period of court-ordered treatment, the medical director of the local mental health treatment agency assigned to supervise and administer the patient's treatment program may file a motion requesting the court to amend the treatment order to place the patient for treatment at the state hospital. After a hearing, if the court finds that the patient's present condition and history demonstrate that the patient will not benefit from a continued period of treatment in or by a local mental health treatment agency, either as an inpatient or an outpatient, or that the state hospital provides a program that is specific to the needs of the patient and is unavailable in a local mental health treatment agency, and that the least restrictive placement to meet the needs of the patient for the foreseeable future is placement in the state hospital and there is a legally available funded bed in the state hospital, the court may amend the original treatment order authorizing the placement of the patient at the state hospital pursuant to section 36-540, subsection A, paragraph 2 or 3.  Within five days after receiving notice from the court, the superintendent shall notify the court whether a bed is available in the state hospital.

D. In computing the number of inpatient treatment days available to a patient under section 36-540, subsection F, any time the patient spent in a jail or prison shall be excluded.
A.R.S. § 36-2284 — Arizona Code / Title 36 / Chapter 22 / Article 2 / Section 2284
36-2284 Infant care review committee
Status: in_force

36-2284. Infant care review committee

A. All health care institutions that provide health care services to infants are encouraged to establish infant care review committees to assist the institutions in delivering health care and related services to infants and in complying with sections 36-2281 and 36-2283. Two or more health care institutions may establish a joint infant care review committee.

B. If any health care institution does not have an infant care review committee, the department of health services may establish an infant care review committee for one or more such institutions.

C. All proceedings, records and materials prepared in connection with reviews by an infant care review committee are confidential and are not subject to discovery, except that:

1. The findings and recommendations of the infant care review committee may be recorded in the infant's medical record.

2. The following information shall be provided on request to the infant's attending or consulting physicians, the infant's parents, legal guardian or custodian or the department of child safety:

(a) The infant's medical record number.

(b) The date and time of the review.

(c) A list of all persons presenting information to the committee.

(d) A list of all persons, including committee members, present during the deliberations of the committee.

(e) The recommendations of the committee.

D. A person present during deliberations of the infant care review committee or having access to its records shall not be subpoenaed to testify in any judicial or quasi-judicial proceeding as to the nature of the discussions held or to the opinions or statements of any person expressed during the proceedings.

E. This section shall not be construed to affect any patient's claim to privilege or privacy or to prevent the subpoena of a patient's medical records if they are otherwise subject to discovery or to restrict the powers and duties of the director pursuant to this chapter with respect to records and information that are not subject to this section. In any legal action brought against a health care institution alleging negligence for failure to adequately conduct an infant care review committee, representatives of the institution are permitted to testify as to whether there was an infant care review committee review concerning the subject matter being litigated. The contents and records of the infant care review committee proceedings are fully confidential and inadmissible as evidence in any court of law except as provided in subsection C of this section.

F. A person who in good faith and without malice takes any action or makes any recommendation as a member, agent or employee of a health care institution infant care review committee, or who furnishes any records, information or assistance to such a committee, is not subject to criminal liability or liability for civil damages or for any legal action in consequence thereof, nor shall the institution or institutions that established the committee or its officers, directors, employees or agents be liable for the activities of any such person. This subsection does not relieve any person of liability arising from treatment of a patient.

G. Any publication by any person of the proceedings of an infant care review committee or of the records or materials prepared in connection with the review by an infant care review committee shall be made only for the purposes provided in subsection C of this section or for research or statistical purposes authorized by the health care institution. Except as provided in subsection C of this section, the identity of any patient whose condition, care or treatment is mentioned in such proceedings, records or materials shall be kept confidential.
A.R.S. § 36-446.09 — Arizona Code / Title 36 / Chapter 4 / Article 6 / Section 446.09
36-446.09 Violations; classification
Status: in_force

36-446.09. Violations; classification

A. Any person who manages, directs and controls the operation of a nursing care institution or an assisted living facility without a current and valid license or certificate as required by this article or who otherwise violates any provisions of this article is guilty of a class 2 misdemeanor. Each day of violation shall constitute a separate offense.

B. Action taken under subsection A shall not be a bar to enforcement of this article and the standards and rules issued and adopted pursuant to this article, by injunction or other appropriate remedy, and the board may institute and maintain in the name of this state any such enforcement proceeding.
A.R.S. § 36-2030 — Arizona Code / Title 36 / Chapter 18 / Article 2 / Section 2030
36-2030 Immunity from criminal or civil liability
Status: in_force

36-2030. Immunity from criminal or civil liability

A peace officer, administrator in charge of an approved treatment facility, or any person who in good faith acts in compliance with this article shall not be criminally or civilly liable.
A.R.S. § 36-472.01 — Arizona Code / Title 36 / Chapter 4.1 / Article 2 / Section 472.01
36-472.01 Billing for laboratory costs; definition
Status: in_force

36-472.01. Billing for laboratory costs; definition

A. A laboratory that provides anatomic pathology services shall not submit a bill to any person or entity other than the following:

1. The patient.

2. The responsible insurer or other third party payor.

3. The health care institution.

4. A referring laboratory, excluding the laboratory of the health professional who ordered the test.

5. A governmental agency or the agency's public or private agent, agency or organization that is acting on behalf of the recipient of the services.

B. For the purposes of this section, "anatomic pathology services" includes cytology services, molecular pathology services, hematopathology, histopathology, surgical pathology, and blood banking services performed by a pathologist.  Anatomic pathology services does not include the collection, packaging and transportation of the specimen.
A.R.S. § 36-142 — Arizona Code / Title 36 / Chapter 1 / Article 2 / Section 142
36-142 Diabetes action plan team; report
Status: in_force

36-142. Diabetes action plan team; report

A. The diabetes action plan team is established in the department of health services.  The team is composed of the head of the following entities or that person's designee:

1. The Arizona diabetes program within the department of health services.

2. The Arizona health care cost containment system.

3. The public safety personnel retirement system.

4. The Arizona state retirement system.

5. The department of administration benefits services division.

6. Diabetes stakeholder organizations, including health insurers, a nationally recognized diabetes association and the Arizona diabetes coalition.

B. The team shall compile a report once every two years that includes the following information:

1. The prevalence in this state of:

(a) Diabetes by type.

(b) Diabetes by age, race and gender.

(c) Complications associated with diabetes.

(d) Prediabetes.

2. The costs of diabetes in this state.

3. The Arizona diabetes program's plan for reducing the incidence of diabetes in this state, improving diabetes care and reducing diabetes-related health disparities, including proposed action steps.

4. A description of the level of coordination that exists between the department of health services and hospitals, the department's contracted partners and other stakeholders on activities and programmatic activities and the level of communication on managing, treating or preventing all forms of diabetes and its complications.

C. The requirements of subsection B, paragraphs 1 and 2 of this section are limited to the diabetes information, data, initiatives and programs within each agency before August 3, 2018, unless there is unobligated funding for diabetes in an agency that may be used for new research, data collection and reporting for the purposes of subsection B, paragraphs 1 and 2 of this section.

D. On or before January 1, 2019 and once every two years thereafter, the department shall provide the report required by subsection B of this section, including its recommendations for action, to the governor, the president of the senate and the speaker of the house of representatives and shall submit a copy to the secretary of state.