Arizona Department of Health Services (ADHS)

AGENCY CONTACT INFORMATION

Arizona Department of Health Services

See also: Arizona Health Care Cost Containment System, Arizona Department of Environmental Quality, Radiation Regulatory Agency, Radiation Regulatory Hearing Board, Medical Radiologic Technology Board of Examiners, and the Vehicle Emissions Inspection Program.

Authority

The Arizona Department of Health Services was established in 1973. Current statutory authority is found at A.R.S. §§36-101 et seq. Administrative rules are found at A.A.C. R9-1-101 et seq.

Function

ADHS was established to protect the physical and mental health of Arizona citizens and to promote the highest standards for licensed health care institutions, emergency services and care facilities for adults and children. Agency responsibilities have changed somewhat since its creation. See “History” section below for detail.

ADHS is responsible for a number of programs including: licensing and regulation of health care and child care facilities; disease control; immunization education and promotion; emergency preparedness; emergency medical services; state laboratory; public health statistics; radiation regulatory programs; and vital records which include birth and death certificates.

ADHS is responsible for operation of the Arizona State Hospital, a state-operated psychiatric inpatient facility providing treatment to adolescents and adults with serious mental illness. (Auditor General Report No. 09-11 and http://www.azdhs.gov)

History

Background

The State Board of Health existed from 1913 until 1974. The State Department of Health existed from 1941 until 1974. The successor agency, the Arizona Department of Health Services (ADHS), established in 1974, absorbed a number of agencies including the State Department of Health, Arizona Health Planning Authority, Crippled Children’s Services, Arizona State Hospital, Pioneers’ Home and Hospital, and the Anatomy Board. ADHS also included the Water Quality Control Council, the Bureau of Air Pollution Control, Bureau of Air Quality Control, Bureau of Water Quality Control and the Bureau of Vehicular Emission Inspection.

The purpose of the 1973 act was to integrate health services in a pattern to reduce duplication of administrative efforts, services and expenditures and promote a means for people with health problems to find a solution in a single department’s coordinated service. (Laws 1973, Chapter 158 – Purpose)

Section 320 of the 1973 measure outlined specific requirements related to the effective date, a transition period and a plan of assumption for the functions that were transferred to ADHS.

The authority, funding, functions and programs that had been repealed and transferred to ADHS were allowed to continue for a period of time in order to allow for establishment of the new agency. An executive order certifying a plan of assumption was required in order to establish an effective date for the new agency. Governor Jack Williams issued a series of executive orders in 1974 (See EO 74-2, EO 74-3, EO 74-4, and EO 74-6). The Director of ADHS was required to work with a legislative committee until July 1, 1975 regarding organization and operation of the Department.

Session Laws

Laws 1941, Chapter 105 established the State Department of Health, responsible for a number of programs, including maternal and child health, nursing, preventive health services, water quality, health records and statistics, the state laboratory, and local health administration.

Laws 1973, Chapter 158 established ADHS, which assumed responsibility for a number of boards and agencies. Section 320 of the act outlined specific requirements regarding the effective date, a transition period and a plan of assumption for the functions that were transferred to ADHS.

Laws 1981, Fourth Special Session, Chapter 1 established the Arizona Health Care Cost Containment System (AHCCCS) as a division within ADHS. It provided for hospitalization and medical care of the indigent sick; provided funding for the system; authorized the director to apply for federal funding; outlined responsibilities of counties, the Arizona Department of Economic Security and ADHS; prescribed requirements for eligibility services, coverage and contracts; and execution of prepaid capitated health service contracts. Coverage began October 1, 1982.

Laws 1984, Chapter 372 established AHCCCS as a stand-alone agency and transferred responsibility, personnel, equipment and funds from ADHS to the new agency.

Laws 1986, Chapter 368 established a new state agency, the Arizona Department of Environmental Quality (ADEQ). The measure transferred oversight of air quality, water quality, solid waste and hazardous waste, and outlined transition and succession of responsibility from ADHS to ADEQ.

Laws 1995, Chapter 257 required a sexually violent person, as determined by the courts, to be

detained in the Arizona State Hospital. The following year, legislation was enacted to place the person under the custody of ADHS, rather than the Arizona Department of Corrections. See also Laws 1996, Chapter 315.

Laws 2000, Chapter 362 designated ADHS as the state’s recipient and administrator of federal Family Violence Prevention and Services Act grants. The measure also designated the Governor’s Office as the state’s recipient of federal Stop Violence Against Women Act grants and designated the Arizona Department of Public Safety as the state’s recipient of federal Victims of Crimes Act grants.

Laws 2000, Fifth Special Session, Chapter 2 established the Serious Mental Illness Services Fund, consisting of monies appropriated to ADHS from the Tobacco Litigation Settlement Account in the state general fund.

Laws 2011, Chapter 27 transferred the Biomedical Research Commission to ADHS, including its duties and responsibilities, which are related to disease control and health research.

A second measure in 2011 transferred responsibility for the Children’s Rehabilitative Services, including personnel, equipment, records and funds, from ADHS to AHCCCS, effective July 1, 2011 (see Laws 2011, Chapter 31).

Laws 2015, Chapter 19 transferred the administration of behavioral health services from ADHS to AHCCCS, effective July 1, 2016. Administration of the Arizona State Hospital remained with ADHS. The measure required conforming language to be drafted the following year in order to complete the transfer of responsibility (see Laws 2016, Chapter 122).

Several measures were enacted in 2017 relating to ADHS:

• Chapter 108 required the Director to exclude information on fetal demise cases from the Hospital Consumer Assessment of Healthcare Providers and Systems Survey.
• Chapter 122 modified licensing requirements for health care institutions and allowed the Director to adopt rules regarding payment of fees.
• Chapter 134 provided specific exemptions from fingerprinting requirements for persons who provide recidivism reduction services at an adult residential care institution and required the Director to adopt rules.
• Chapter 234 established the Drug Overdose Review Team within ADHS to develop a drug overdose facilities data collections system. The measure outlined goals, access to information, confidentiality and provided a termination date of January 2023 for the Review Team.
• Chapter 288 authorized the Director to take steps to enhance the use of the Arizona State Hospital, including contracting with third parties and entering into short-term lease agreements to develop the land and buildings. The measure established the Arizona State Hospital Charitable Trust Fund and outlined information to be reported to the Joint Committee on Capital Review.
• Chapter 313 transferred responsibilities, personnel, equipment and funds of three entities to ADHS: Arizona Radiation Regulatory Agency (ARRA), Arizona Radiation Regulatory Hearing Board (RRHB); and the Medical Radiologic Technology Board of Examiners (MRTBE). Duties relate to regulating, inspecting and licensing the use, storage and sources of radiation state wide. See related histories for ARRA and MRTBE, elsewhere in this document.

 

Governor Ducey declared a state of emergency in June, 2017 regarding the opioid overdose epidemic and authorized the Department of Emergency and Military Affairs to coordinate state assets. In addition, the Governor authorized ADHS to: coordinate a public health emergency response; take specific steps to address the issue; and produce a report of findings and recommendations by September 5, 2017.

A legislative special session, called in January 2018, established responsibilities for several agencies. Among other requirements, certain provisions of Laws 2018, First Special Session, Chapter 1 outlined ADHS responsibilities related to substance abuse treatment, pain management clinics and reporting requirements. The measure also created the Substance Abuse Disorder Services Fund and appropriated $400,600 from the fund in FY 2018 to ADHS for opioid abuse prevention efforts.

Laws 2018, Chapter 234 repealed the RRHB and the MRTBE and provided that hearings and appeals of ADHS decisions would be conducted by the Arizona Office of Administrative Hearings. The measure also authorized the ADHS Director to appoint an advisory committee to assist with duties related to the regulation of radiologic technologists.

Several measures were enacted in 2019 relating to ADHS:

• Chapter 104 required an annual report on veteran suicides to be compiled by ADHS and directs the Department of Veterans Services to provide information.
• Chapter 133 established state health care institution licensure requirements for intermediate care facilities that serve individuals with intellectual disabilities. The measure prohibits DHS from accepting any accreditation reports in lieu of licensure or inspection requirements.
• Chapter 134 established a 24-hour reporting requirement for cases of abuse or neglect at residential facilities providing behavioral health services to children. DHS is required to adopt administrative rules for employees and personnel of those residential facilities.
• Chapter 173 outlined responsibilities of the Independent Oversight Committee (IOC) related to treatment of seriously mentally ill patients at the Arizona State Hospital (ASH). Required ASH to provide specific information to the IOC. Note: See Department of Administration agency history in this collection for additional information on IOCs enacted in 2018.
• Chapter 195 adds a section providing for temporary licensure of health professions. ADHS is the licensing agency for certain health professions including radiologic technologists; clinical laboratories; midwives; and hearing dispensers, audiologists and speech-language pathologists. The new section 32-3124.A states in part: “A health profession regulatory board in this state may issue a temporary license to allow an applicant who is not a licensee to practice…”. The section sets specific requirements and authorizes the adoption of rules to carry out the new provisions. The new section 32-3124.I states: “This section applies to a health profession regulatory board to the extent that this section does not conflict with the board’s current statutory authority relating to temporary licensure.”
• Chapter 215 established the Health Care Professionals Workforce Data Repository within DHS and created the Workforce Data Repository Fund, administered by the DHS Director. The measure also formed the Health Care Professionals Workforce Data Repository Advisory Committee and outlined membership of the Committee.
• Chapter 227 classifies the unauthorized practice of a health profession as a Class 5 felony. It requires regulatory boards to investigate complaints and authorizes them to issue cease and desist orders or refer complaints to the county attorney or attorney general for prosecution.
• Chapter 316 required ADHS to adopt rules, in consultation with the Department of Education, to implement vision screening services for students. Each school is required to provide vision screening services to students based on criteria described in the measure.
• Chapter 318 required ADHS to certify and regulate third-party laboratories that analyze marijuana cultivated for medical use; outlined related DHS responsibilities; and required ADHS to establish a Medical Marijuana Testing Advisory Council. The measure outlined Council membership and duties, and contains two legislative intent clauses.

 

Laws 2020, Chapter 4, the mental health omnibus measure also known as Jake’s Law, outlined responsibilities for several agencies relating to programs for mental health or substance abuse disorders.  The measure required DHS to adopt administrative rules to address: admission and discharge protocols for patients who have attempted suicide; information regarding crisis services and care after discharge; how to challenge adverse decisions by a health care insurer or health plan; and conducting suicide assessments prior to discharge.  The measure also established the 24-member Suicide Mortality Review Team within DHS and prescribed its duties.

A second measure enacted in 2020 appropriated $5 million from the budget stabilization fund to the Public Health Emergencies Fund to cover expenses related to the COVID-19 state of emergency.  DHS is required to notify the Joint Legislative Budget Committee of intended use of the monies prior to expenditures.  See Laws 2020, Chapter 6.

A third measure enacted in 2020 expanded and modified fingerprint clearance card requirements for persons with access to vital records systems and for employees who inspect child care or vulnerable adult facilities.  The measure also included provisions related to DES and DPS.  See Laws 2020, Chapter 86.

Several measures were adopted in 2021 relating to ADHS:

• Chapter 282 outlines certification requirements and scope of practice for doulas. Creates the Doula Community Advisory Committee, specifies committee membership and prescribes its duties.
• Chapter 320 requires ADHS to develop a three-year pilot program for state licensed hospitals to deliver acute care in-home services by September 1, 2021.  Reports are due December 1, 2021 and June 30, 2022. The section is repealed after December 31, 2024.
• Chapter 402 expands the information required to be included in the Arizona State Hospital (ASH) annual financial and programmatic report; requires ADHS and ADOA to issue a request for information for a surveillance system for ASH; and establishes the Joint Legislative Psychiatric Hospital Review Council to review specific issues relating to inpatient psychiatric treatment.

Six measures relating to marijuana were enacted in 2021:

• Chapter 386 requires ADHS to conduct proficiency testing and remediate problems with independent, third-party laboratories and marijuana testing facilities.
• Chapter 387 authorizes ADHS to inspect a medical marijuana dispensary.
• Chapter 394 outlines ADHS responsibilities for developing packaging, labeling and tracking requirements for marijuana and marijuana products.
• Chapter 398 provides grant funding to research the correlation between marijuana use and mental illness. Also requires a warning label for marijuana packaging.
• Chapter 419 establishes a grant program for marijuana clinical trials to evaluate the safety and efficacy of using marijuana and to research the impacts of interactions between marijuana and other drugs.
• Chapter 439 outlines requirements for testing medical marijuana products for contamination; modifies membership and duties of the Medical Marijuana Testing Advisory Council and prohibits relationships between testing facilities and a marijuana business entity or company.

Sources

• Revised Statutes of Arizona – 1913 Civil Code, paragraph 4367
• Arizona Revised Statutes §§36-101 et seq.
• Arizona Administrative Code §§R9-1-101 et seq.
• Session Laws
  • Laws 1941, Chapter 105
  • Laws 1973, Chapter 158
  • Laws 1981, Fourth Special Session, Chapter 1
  • Laws 1984, Chapter 372
  • Laws 1986, Chapter 368
  • Laws 1995, Chapter 257
  • Laws 1996, Chapter 315
  • Laws 2000, Chapter 362
  • Laws 2000, Fifth Special Session, Chapter 2
  • Laws 2011, Chapter 27 and Chapter 31
  • Laws 2015, Chapter 19
  • Laws 2016, Chapter 122
  • Laws 2017, Chapter 108, Chapter 122, Chapter 134, Chapter 234, Chapter 288, Chapter 313
  • Laws 2018, Chapter 234
  • Laws 2018, First Special Session, Chapter 1
  • Laws 2019, Chapter 104, Chapter 133, Chapter 134, Chapter 173, Chapter, 195, Chapter 215, Chapter 227, Chapter 316, and Chapter 318
  • Laws 2020, Chapter 4, Chapter 6, and Chapter 86
  • Laws 2021, Chapter 282, Chapter 320, Chapter 386, Chapter 387, Chapter 394, Chapter 398, Chapter 402, Chapter 419, and Chapter 439

 

Governor Jack Williams Executive Orders issued in 1974: EO 74-2; EO 74-3; EO 74-4; EO 74-6

Governor Doug Ducey Executive Orders: EO 2017-04 and EO 2017-05.

Department of Health Services website

Opioid Action Plan: Opioid Overdose Epidemic Response Report. September 2017.

Sunset Review – Arizona Department of Health Services, September 2009. Arizona Auditor General Report No. 09-11.

Related collections at Arizona State Archives

• RG 50 – Department of Health Services