A.R.S. tit. 36 ch. 5 — Arizona Revised Statutes Title 36 Chapter 5 — Mental Health Services

36-501. Definitions In this chapter, unless the context otherwise requires: 1. "Administration" means the Arizona health care cost containment system administration. 2. "Admitting officer" means a psychiatrist or other physician or psychiatric and mental health nurse practitioner with experience in performing psychiatric examinations who has been designated as an admitting officer of the evaluation agency by the person in charge of the evaluation agency. 3. "Authorized transporter" means a transportation entity that is contracted with a city, town or county to provide services pursuant to this chapter and that is either: (a) An ambulance service that holds a valid certificate of necessity. (b) A transportation provider authorized by this state to provide safe behavioral health transportation for individuals requiring transportation pursuant to this chapter. 4. "Chief medical officer" means the chief medical officer under the supervision of the superintendent of the state hospital. 5. "Contraindicated" means that access is reasonably likely to endanger the life or physical safety of the patient or another person. 6. "Court" means the superior court in the county in this state in which the patient resides or was found before screening or emergency admission under this title. 7. "Criminal history" means police reports, lists of prior arrests and convictions, criminal case pleadings and court orders, including a determination that the person has been found incompetent to stand trial pursuant to section 13-4510. 8. "Danger to others" means that the judgment of a person who has a mental disorder is so impaired that the person is unable to understand the person's need for treatment and as a result of the person's mental disorder the person's continued behavior can reasonably be expected, on the basis of competent medical opinion, to result in serious physical harm. 9. "Danger to self": (a) Means behavior that, as a result of a mental disorder: (i) Constitutes a danger of inflicting serious physical harm on oneself, including attempted suicide or the serious threat thereof, if the threat is such that, when considered in the light of its context and in light of the individual's previous acts, it is substantially supportive of an expectation that the threat will be carried out. (ii) Without hospitalization will result in serious physical harm or serious illness to the person. (b) Does not include behavior that establishes only the condition of having a grave disability. 10. "Department" means the department of health services. 11. "Detention" means the taking into custody of a patient or proposed patient. 12. "Director" means the director of the administration. 13. "Evaluation" means: (a) A professional multidisciplinary analysis that may include firsthand observations or remote observations by interactive audiovisual media and that is based on data describing the person's identity, biography and medical, psychological and social conditions carried out by a group of persons consisting of at least the following: (i) Two licensed physicians who are qualified psychiatrists, if possible, or at least experienced in psychiatric matters, who shall examine and report their findings independently. The person against whom a petition has been filed shall be notified that the person may select one of the physicians. A psychiatric resident in a training program approved by the American medical association or by the American osteopathic association may examine the person in place of one of the psychiatrists if the resident is supervised in the examination and preparation of the affidavit and testimony in court by a qualified psychiatrist appointed to assist in the resident's training, and if the supervising psychiatrist is available for discussion with the attorneys for all parties and for court appearance and testimony if requested by the court or any of the attorneys. (ii) Two other individuals, one of whom, if available, is a psychologist and in any event a social worker familiar with mental health and human services that may be available placement alternatives appropriate for treatment. An evaluation may be conducted on an inpatient basis, an outpatient basis or a combination of both, and every reasonable attempt shall be made to conduct the evaluation in any language preferred by the person. (b) A physical examination that is consistent with the existing standards of care and that is performed by one of the evaluating physicians or by or under the supervision of a physician who is licensed pursuant to title 32, chapter 13 or 17 or a registered nurse practitioner who is licensed pursuant to title 32, chapter 15 if the results of that examination are reviewed or augmented by one of the evaluating physicians. 14. "Evaluation agency" means either of the following: (a) A health care agency that is licensed by the department and that has been approved pursuant to this title to provide the services required of that agency by this chapter. (b) A facility that is exempt from licensure pursuant to section 36-402, that possesses an accreditation from either a national commission on correctional health care or an American correctional association and that has been approved pursuant to this title to provide the services required of that facility by this chapter. 15. "Family member" means a spouse, parent, adult child, adult sibling or other blood relative of a person undergoing treatment or evaluation pursuant to this chapter. 16. "Grave disability" means a condition evidenced by behavior in which a person, as a result of a mental disorder, is likely to come to serious physical harm or serious illness because the person is unable to provide for the person's own basic physical needs. 17. "Health care decision maker" has the same meaning prescribed in section 12-2801. 18. "Health care entity" means a health care provider, the department, the administration or a regional behavioral health authority that is under contract with the administration. 19. "Health care provider" means a health care institution as defined in section 36-401 that is licensed as a behavioral health provider pursuant to department rules or a mental health provider. 20. "Independent evaluator" means a licensed physician, psychiatric and mental health nurse practitioner or psychologist who is selected by the person to be evaluated or by the person's attorney. 21. "Informed consent" means a voluntary decision following the presentation of all facts necessary to form the basis of an intelligent consent by the patient or guardian with no minimizing of known dangers of any procedures. 22. "Least restrictive treatment alternative" means the treatment plan and setting that infringe in the least possible degree with the patient's right to liberty and that are consistent with providing needed treatment in a safe and humane manner. 23. "Licensed physician" means any medical doctor or doctor of osteopathy who is either: (a) Licensed in this state. (b) A full-time hospital physician licensed in another state and serving on the staff of a hospital operated or licensed by the United States government. 24. "Medical director of an evaluation agency" means a psychiatrist, or other licensed physician experienced in psychiatric matters, who is designated in writing by the governing body of the agency as the person in charge of the medical services of the agency for the purposes of this chapter and may include the chief medical officer of the state hospital. 25. "Medical director of a mental health treatment agency" means a psychiatrist, or other licensed physician experienced in psychiatric matters, who is designated in writing by the governing body of the agency as the person in charge of the medical services of the agency for the purposes of this chapter and includes the chief medical officer of the state hospital. 26. "Mental disorder" means a substantial disorder of the person's emotional processes, thought, cognition or memory. Mental disorder is distinguished from: (a) Conditions that are primarily those of drug abuse, alcoholism or intellectual disability, unless, in addition to one or more of these conditions, the person has a mental disorder. (b) The declining mental abilities that directly accompany impending death. (c) Character and personality disorders characterized by lifelong and deeply ingrained antisocial behavior patterns, including sexual behaviors that are abnormal and prohibited by statute unless the behavior results from a mental disorder. 27. "Mental health provider" means any physician or provider of mental health or behavioral health services who is involved in evaluating, caring for, treating or rehabilitating a patient. 28. "Mental health treatment agency": (a) Means any of the following: (i) The state hospital. (ii) A health care agency that is licensed by the department and that provides the services that are required of the agency by this chapter. (iii) A facility that is exempt from licensure pursuant to section 36-402, that possesses an accreditation from either a national commission on correctional health care or an American correctional association and that provides the services that are required of the facility by this chapter. (b) Does not include a secure behavioral health residential facility that provides services only to persons placed in the facility pursuant to a court order issued pursuant to section 36-550.09. 29. "Outpatient treatment" or "combined inpatient and outpatient treatment" means any treatment program that does not require continuous inpatient hospitalization. 30. "Outpatient treatment plan" means a treatment plan that does not require continuous inpatient hospitalization. 31. "Patient" means any person who is undergoing examination, evaluation or behavioral or mental health treatment under this chapter. 32. "Peace officers" means sheriffs of counties, constables, marshals and policemen of cities and towns. 33. "Persistent or acute disability" means a severe mental disorder that meets all the following criteria: (a) Significantly impairs judgment, reason, behavior or capacity to recognize reality. (b) If not treated, has a substantial probability of causing the person to suffer or continue to suffer severe and abnormal mental, emotional or physical harm. (c) Substantially impairs the person's capacity to make an informed decision regarding treatment, and this impairment causes the person to be incapable of understanding and expressing an understanding of the advantages and disadvantages of accepting treatment and understanding and expressing an understanding of the alternatives to the particular treatment offered after the advantages, disadvantages and alternatives are explained to that person. (d) Has a reasonable prospect of being treatable by outpatient, inpatient or combined inpatient and outpatient treatment. 34. "Prepetition screening" means the review of each application requesting court-ordered evaluation, including an investigation of facts alleged in the application, an interview with each applicant and an interview, if possible, with the proposed patient. The purpose of the interview with the proposed patient is to assess the problem, explain the application and, when indicated, attempt to persuade the proposed patient to receive, on a voluntary basis, evaluation or other services. 35. "Prescribed form" means a form established by a court or the rules of the administration in accordance with the laws of this state. 36. "Professional" means a physician who is licensed pursuant to title 32, chapter 13 or 17, a psychologist who is licensed pursuant to title 32, chapter 19.1 or a psychiatric and mental health nurse practitioner who is certified pursuant to title 32, chapter 15. 37. "Proposed patient" means a person for whom an application for evaluation has been made or a petition for court-ordered evaluation has been filed. 38. "Prosecuting agency" means the county attorney, attorney general or city attorney who applied or petitioned for an evaluation or treatment pursuant to this chapter. 39. "Psychiatric and mental health nurse practitioner" means a registered nurse practitioner as defined in section 32-1601 who has completed an adult or family psychiatric and mental health nurse practitioner program and who is certified as an adult or family psychiatric and mental health nurse practitioner by the state board of nursing. 40. "Psychiatrist" means a licensed physician who has completed three years of graduate training in psychiatry in a program approved by the American medical association or the American osteopathic association. 41. "Psychologist" means a person who is licensed under title 32, chapter 19.1 and who is experienced in the practice of clinical psychology. 42. "Records" means all communications that are recorded in any form or medium and that relate to patient examination, evaluation or behavioral or mental health treatment. Records include medical records that are prepared by a health care provider or other providers. Records do not include: (a) Materials that are prepared in connection with utilization review, peer review or quality assurance activities, including records that a health care provider prepares pursuant to section 36-441, 36-445, 36-2402 or 36-2917. (b) Recorded telephone and radio calls to and from a publicly operated emergency dispatch office relating to requests for emergency services or reports of suspected criminal activity. 43. "Regional behavioral health authority" has the same meaning prescribed in section 36-3401. 44. "Screening agency" means a health care agency that is licensed by the department and that provides those services required of the agency by this chapter. 45. "Social worker" means a person who has completed two years of graduate training in social work in a program approved by the council of social work education and who has experience in mental health. 46. "State hospital" means the Arizona state hospital. 47. "Superintendent" means the superintendent of the state hospital. 48. "Voluntary evaluation" means the ongoing collection and analysis of a person's medical, psychological, psychiatric and social conditions in order to initially determine if a health disorder exists and if there is a need for behavioral health services and, on an ongoing basis, to ensure that the person's service plan is designed to meet the person's and the person's family's current needs and long-term goals. 36-502. Powers and duties of the director of AHCCCS; rules; expenditure limitation; reporting requirements; definition A. The administration is responsible for monitoring, overseeing and evaluating its contractors and the contracted agencies providing services under this chapter to ensure that the services are provided in a timely, clinically effective and efficient manner. The administration and its contractors shall monitor the performance of an agency providing services pursuant to this chapter. The administration shall take corrective action, which may include technical assistance, and impose civil penalties pursuant to section 36-2918, if appropriate, suspension and termination of contracts, for agencies that the administration finds to not be in compliance with county, state and federal laws and rules or to not be performing the services in a timely, effective and efficient manner. B. The director shall adopt rules that include standards for agencies other than the state hospital when providing services and shall prescribe forms as may be necessary for the proper administration and enforcement of this chapter. The rules shall be applicable to patients admitted to or treated in agencies, other than the state hospital, as set forth in this chapter and shall provide for periodic inspections of such agencies. C. The director shall adopt rules, if necessary, and prescribe reporting requirements and standards for contractors and contracted agencies to collect, report and analyze information and data for the purpose of understanding the clinical effectiveness of services provided by the various agencies pursuant to this chapter. The administration shall analyze the information and data collected semiannually and shall report annually to the governor, the president of the senate and the speaker of the house of representatives beginning on or before December 31, 2025. For the purposes of this subsection, the information and data shall identify and measure clinical outcomes in the past year of members who have received a designation of serious mental illness, including all of the following: 1. The number of hospitalizations and rehospitalizations, the facilities where admissions occurred and the average length of stay by admitting diagnosis, for members for whom the administration or its contractor is the primary payor. 2. The number and percentage of members with a mental health disorder and co-occurring substance use disorder diagnosis who were admitted, discharged and subsequently readmitted to an inpatient psychiatric facility within the preceding year, for members for whom the administration or its contractor is the primary payor. 3. The number and percentage of members whose title XIX enrollment is placed in a no-pay status in a given year due to the member's incarceration status, stratified by the number of times enrollment is suspended. 4. The number of members for whom the administration or its contractor is notified of a release from incarceration and for whom the administration or its contractor conducts reach-in services. 5. The number of responses by the contracted crisis system that identify members with a serious mental illness designation, including: (a) The number of crisis phone line calls received. (b) The number of mobile teams dispatched. (c) The number of members seen at psychiatric urgent care centers. (d) The number of members with two or more distinct crisis system episodes. 6. The number of member deaths, the death rate and the cause of death in the preceding year. 7. The number of members who are homeless, unsheltered or inadequately housed and for what period of time, as identified through homeless management information system data or other available sources identified by the administration. 8. The number of title XIX members or non-title XIX grant-funded members, separately delineated, who are: (a) Admitted to a behavioral health residential facility. (b) Discharged from a behavioral health residential facility. (c) For those members for whom the administration or its contractor is the primary payor, admitted to an inpatient psychiatric hospital within one year after discharge from the behavioral health residential facility. 9. The number and percentage of members who: (a) Have received court-ordered treatment. (b) Have requested and received the removal of a serious mental illness designation. (c) Have received court-ordered treatment and are adherent to the court-ordered treatment. (d) Did not receive a single behavioral health service. 10. The number of patients who have been discharged from the state hospital and admitted to a contracted psychiatric hospital within the preceding year. 11. The number of members who have been evaluated for a serious mental illness eligibility determination, the number of members whose eligibility determination resulted in receiving a serious mental illness designation and the number of members whose eligibility determination resulted in not receiving a serious mental illness designation. 12. The number of members who are also enrolled in medicare and when the member's medicare enrollment became known to the administration, separately reported by title XIX and non-title XIX members. D. The director shall adopt rules concerning the admission of patients and the transfer of patients between mental health treatment agencies other than the state hospital. A patient undergoing court-ordered treatment may be transferred from one mental health treatment agency to another in accordance with the rules of the director, subject to the approval of the court. E. The director may adopt rules concerning leaves, visits and absences of patients from evaluation agencies and mental health treatment agencies other than the state hospital. F. The total amount of state monies that may be spent in any fiscal year by the administration for mental health services pursuant to this chapter may not exceed the amount appropriated or authorized by section 35-173 for that purpose. This chapter does not impose a duty on an officer, agent or employee of this state to discharge a responsibility or create any right in a person or group if the discharge or right would require an expenditure of state monies in excess of the expenditure authorized by legislative appropriation for that specific purpose. G. The requirements of subsection C of this section shall be implemented not later than October 1, 2025. On or before December 31, 2024, the administration shall file an interim report with the governor, the president of the senate and the speaker of the house of representatives that describes the plan of the administration in completing the requirements of this section. On or before December 31, 2025, the administration shall file a report with the governor, the president of the senate and the speaker of the house of representatives confirming the implementation of the requirements of this section. H. For the purposes of this section, "member" has the same meaning prescribed in section 36-2901. 36-502.01. Powers and duties of director of the department of health services; rules; expenditure limitation A. The director of the department shall make rules that include standards for the state hospital when providing services as an evaluation agency or mental health agency and shall prescribe forms as may be necessary for the proper administration and enforcement of those responsibilities. The rules shall be applicable to patients admitted to, evaluated by or treated in the state hospital as set forth in this chapter and shall provide for periodic inspections of the state hospital. B. The director of the department shall make rules concerning the admission of patients to the state hospital and the transfer of patients between the state hospital and other mental health treatment agencies. A patient undergoing court-ordered treatment may be transferred between the state hospital and another mental health treatment agency in accordance with the rules of the director of the department, subject to the approval of the court. The director of the department shall consult with the director of the administration on rules relating to transfers to and from the state hospital and other mental health treatment agencies. C. The director of the department may make rules concerning leaves, visits and absences of patients from the state hospital. D. The total amount of state monies that may be spent in any fiscal year by the department for mental health services pursuant to this chapter may not exceed the amount appropriated or authorized by section 35-173 for that purpose. This chapter does not impose a duty on an officer, agent or employee of this state to discharge a responsibility or create any right in a person or group if the discharge or right would require an expenditure of state monies in excess of the expenditure authorized by legislative appropriation for that specific purpose. 36-503. Medical director of evaluation agency or mental health treatment agency; deputy The medical director of an evaluation agency or the medical director of a mental health treatment agency may deputize, in writing, subject to the approval of the governing body of the agency, any qualified psychiatrist or licensed physician on the staff of the agency to do or perform in his stead any act the medical director is empowered to do or charged with responsibility of doing pursuant to this chapter. 36-503.01. Duty of attorney general or county attorney Whenever a physician or other person files a petition for court-ordered evaluation or court-ordered treatment on behalf of a state or county screening, evaluation or mental health treatment agency, the attorney general or the county attorney for the county in which the proceeding is initiated, as the case may be, shall represent the individual or agency in any judicial proceeding for involuntary detention or commitment and shall defend all challenges to such detention or commitment. 36-503.02. Apprehension and transportation by authorized transporters; immunity A. When in any section of articles 4 and 5 of this chapter, a court, a person, an evaluation agency or a mental health treatment agency is allowed to authorize, request or order the apprehension and transportation of a patient or proposed patient by a peace officer to an evaluation agency or mental health treatment agency, the court, person, evaluation agency or mental health treatment agency may authorize the apprehension and transportation by an authorized transporter if available in the city, town or county if there are reasonable grounds to believe that the patient or proposed patient may be safely apprehended and transported by an authorized transporter without the assistance of a peace officer. B. Any person who provides a court, a person, an evaluation agency or a mental health treatment agency authorized to request or order the apprehension and transportation of a patient or proposed patient with facts and circumstances or expresses an opinion that there may be reasonable grounds to believe a patient or proposed patient may be safely apprehended and transported to an evaluation agency or mental health treatment agency by an authorized transporter without the assistance of a peace officer, the court, the person, the evaluation agency or the mental health treatment agency that authorizes the use of an authorized transporter and the authorized transporter that apprehends and transports the patient or proposed patient to an evaluation agency or mental health treatment agency pursuant to an authorization, request or order issued under this chapter are not subject to civil liability for the apprehension or transportation. This liability exclusion does not apply to a person who acts with gross negligence. C. This chapter does not require a city, town or county to contract with an authorized transporter to provide services pursuant to this chapter instead of a peace officer. A city, town or county that enters into a contract with an authorized transporter is financially responsible for the contracted services provided pursuant to this chapter by the authorized transporter. D. For the purposes of this chapter, an evaluation agency or mental health treatment agency authorizing the use of an authorized transporter is not financially responsible for the use of the authorized transporter. 36-503.03. Civil commitment treatment population; cap The Arizona state hospital shall collect census data for adult civil commitment treatment programs to establish maximum capacity and the allocation formula required by section 36-206, subsection D. The Arizona state hospital or the department of health services is not required to provide civil commitment treatment that exceeds the funded capacity. If the Arizona state hospital reaches its funded capacity in civil commitment treatment programs, the superintendent of the state hospital shall establish a waiting list for admission based on the date of the court order issued pursuant to this section. 36-503.04. Maternal mental health conditions; educational materials and information; distribution; definitions A. The department shall identify and compile relevant educational materials and information for health care professionals and patients regarding maternal mental health conditions, including postpartum depression, that have been developed by organizations with expertise in maternal mental health conditions. The materials shall include information on the symptoms and methods of coping with postpartum depression, as well as treatment options and resources. If the department is unable to identify existing materials that comply with the requirements of this subsection, the department shall develop written educational materials and information, taking into consideration relevant clinical practice guidelines, peer-reviewed studies and recommendations from experts in maternal mental health care, including the centers for disease control and prevention, professional associations and patient advocacy groups. B. The department shall post the materials and information required by subsection A of this section on its public website. The department shall make available or distribute the materials and information in physical form on request. C. The department shall periodically review the materials and information to determine their accuracy and ensure that they reflect the most up-to-date and accurate information. D. A health care institution shall provide each departing new parent and other family members, as appropriate, with written materials and information compiled or developed pursuant to subsection A of this section on the new parent's discharge from the health care institution. E. Each health care institution, primary care physician and primary care practitioner, or any other health professional who renders prenatal or postnatal care or who provides pediatric infant care, shall provide the materials and information compiled or developed pursuant to subsection A of this section to any woman on learning of a pregnancy or who presents with signs of a maternal mental health disorder at any time during a pregnancy or postpartum period. F. For the purposes of this section: 1. "Health care institution" has the same meaning prescribed in section 36-401. 2. "Primary care physician" and "primary care practitioner" have the same meanings prescribed in section 36-2901. 36-503.05. Mental health patients; proposed patients; transportation; use of peace officers prohibited; exceptions (Eff. 1/1/30) A. Notwithstanding any other law to the contrary, a peace officer may not conduct the transport of a person from a hospital emergency department or a locked unit of a behavioral health facility to another health care institution, an evaluation agency or a mental health treatment agency, unless one of the following applies: 1. The person is incarcerated. 2. A court, a person, an evaluation agency or a mental health treatment agency has reasonable grounds to believe that the patient or proposed patient cannot be safely apprehended without the assistance of a peace officer. 3. Any person requests a peace officer by dialing 911 or a similar designated telephone number for emergency calls and needs emergency assistance. B. Except as provided in subsection A of this section, an authorized transporter shall conduct any apprehension and transport of a patient or proposed patient. 36-504. Notice of patients' rights; notification to family A. Every person undergoing treatment or evaluation pursuant to this chapter is entitled to the rights set forth in this chapter and to rights that the director specifies by rule. A list of patients' rights as required by this chapter and by the administration shall be compiled and published by the director by rule. The list shall be prominently posted in English and Spanish in all facilities providing evaluation or treatment. A patient's rights shall otherwise be brought to the attention of the patient as this chapter requires or the director may direct by rule. B. An agency that is evaluating, examining or treating a person pursuant to article 4 or 5 of this chapter shall immediately notify the person's guardian or, if none, a member of the person's family that the person is being treated in the agency. If the person has an agent appointed pursuant to chapter 32 of this title, the agency shall notify that agent. If the agency is unable to learn the identity of or to contact the guardian or member of the person's family, it shall document every attempt that was made to comply with the notification. The agency shall release any further information only after the treating professional or that person's designee interviews the person undergoing treatment or evaluation to determine whether or not release is in that person's best interests. A decision to release or withhold information is subject to review pursuant to section 36-517.01. The treating agency shall record the name of a person to whom any information is given. 36-504.01. Guardians and agents; rights in proceedings Guardians and agents who have decisional authority to make personal, medical and treatment decisions for a patient pursuant to an order of the court or pursuant to a validly executed mental health power of attorney in which the principal has been found incapable of giving informed consent have the following rights in any proceedings under this article regarding involuntary treatment of the patient: 1. To be notified of any petition for treatment, motion for amended court order, application for continued court-ordered treatment and request for judicial review. 2. If allowed by the court, to provide the court with the guardian's or agent's position regarding the relief being sought in any of the proceedings set forth in paragraph 1 of this section and to provide the court with any relevant information to help the court make a determination. 3. To provide relevant information to any agency providing inpatient or outpatient screening, evaluation or treatment to the patient. 4. When appropriate, to participate in treatment and discharge planning with the inpatient or outpatient treatment providers. 36-505. Rights at hearing; virtual proceedings A. At all hearings conducted pursuant to this chapter, persons shall have the right to an analysis of their psychological condition by an independent evaluator. B. In any proceeding held pursuant to this chapter, the court, on its own or for good cause shown by a party, may order the hearing to be conducted or may allow a witness or party to appear and give testimony virtually through the use of telephone, videoconferencing or other audiovisual technology if the court finds that this procedure will not unfairly prejudice a party or witness. In determining whether a proceeding should be conducted wholly or partially with the use of telephone, videoconferencing or other audiovisual technology, the court shall consider the inconvenience to or burden on a party or witness to attend the proceeding in person and the ability of all parties to be heard by other parties in attendance, including the judicial officer and, if applicable, the certified reporter or an electronic recording system. The supreme court may adopt rules to govern the procedures to be used in conducting proceedings virtually pursuant to this chapter. 36-506. Civil rights not impaired; discrimination prohibited A. Persons undergoing evaluation or treatment pursuant to this chapter shall not be denied any civil right, including but not limited to, the right to dispose of property, sue and be sued, enter into contractual relationships and vote. Court-ordered treatment or evaluation pursuant to this chapter is not a determination of legal incompetency, except to the extent provided in section 36-512. B. A person who is or has been evaluated or treated in an agency for a mental disorder shall not be discriminated against in any manner, including but not limited to: 1. Seeking employment. 2. Resuming or continuing professional practice or previous occupation. 3. Obtaining or retaining housing. 4. Obtaining or retaining licenses or permits, including but not limited to, motor vehicle licenses, motor vehicle operators and chauffeurs licenses and professional or occupational licenses. C. "Discrimination" for purposes of this section means any denial of civil rights on the grounds of hospitalization or outpatient care and treatment unrelated to a person's present capacity to meet the standards applicable to all persons. Applications for positions, licenses and housing shall contain no requests for information which encourage such discrimination. D. Upon discharge from any treatment or evaluation agency, the patient shall be given written notice of the provisions of this section. 36-507. Patient's rights to privacy and to personal possessions Every person undergoing evaluation or treatment pursuant to this chapter: 1. Has the right not to be fingerprinted. 2. Has the right not to be photographed without consent of the person and the person's attorney or guardian, except that the person may be photographed upon admission to an agency for identification and administrative purposes of the agency. All photographs shall be confidential and shall not be released by the agency except pursuant to court order. 3. Has the right to examine the written treatment program and the medical record, unless the attending physician or the physician's designee who is a health professional as defined in section 32-3201 determines that such an examination is contraindicated or the requirements of section 12-2293, subsection B are met. If the attending physician or the physician's designee denies such an examination, this determination shall be noted in the patient's medical record. 4. Has access to individual storage space for his private use while undergoing evaluation or treatment. 5. May wear the person's own clothing, keep and use the person's own personal possessions including toilet articles and to keep and be allowed to spend a reasonable sum of the person's own money for the person's own needs and comfort. Notwithstanding section 36-516, the director of the agency may deny the patient's rights under this paragraph if necessary to protect the safety of the patient or others. The denial shall be based on a written determination and entered into the patient's clinical record and that information shall be made available on request to the person or the person's attorney or guardian. 36-508. Disposition of patient's personal property A. When a patient is admitted on an inpatient basis to a mental health treatment agency pursuant to section 36-540, the articles of personal property which cannot be used by the patient at the institution shall be placed under the control and management of the patient's guardian or conservator and, if none, of the patient's spouse or next of kin. B. In the event the patient is without a guardian, conservator, spouse or next of kin, or the spouse or next of kin refuses to take possession of the patient's personal property that cannot be used by the patient at the mental health treatment agency, the mental health treatment agency shall provide reasonable facilities for the storage of the patient's personal property. C. Upon application by any interested person, the court shall enter an appropriate order for the protection of the proposed patient's property where no other alternatives exist to prevent the immediate loss or destruction of that property. 36-509. Confidential records; immunity; definition A. A health care entity must keep records and information contained in records confidential and not as public records, except as provided in this section. Records and information contained in records may be disclosed only as authorized by state or federal law, including the health insurance portability and accountability act privacy standards (45 Code of Federal Regulations part 160 and part 164, subpart E), or as follows to: 1. Physicians and providers of health, mental health or social and welfare services involved in caring for, treating or rehabilitating the patient. 2. Individuals to whom the patient or the patient's health care decision maker has given authorization to have information disclosed. 3. Persons authorized by a court order. 4. Persons doing research only if the activity is conducted pursuant to applicable federal or state laws and regulations governing research. 5. The state department of corrections in cases in which prisoners confined to the state prison are patients in the state hospital on authorized transfers either by voluntary admission or by order of the court. 6. Governmental or law enforcement agencies if necessary to: (a) Secure the return of a patient who is on unauthorized absence from any agency where the patient was undergoing evaluation and treatment. (b) Report a crime on the premises. (c) Avert a serious and imminent threat to an individual or the public. 7. Persons, including family members, other relatives, close personal friends or any other person identified by the patient, as otherwise authorized or required by state or federal law, including the health insurance portability and accountability act of 1996 privacy standards (45 Code of Federal Regulations part 160 and part 164, subpart E), or pursuant to one of the following: (a) If the patient is present or otherwise available and has the capacity to make health care decisions, the health care entity may disclose the information if one of the following applies: (i) The patient agrees verbally or agrees in writing by signing a consent form that permits disclosure. (ii) The patient is given an opportunity to object and does not express an objection. (iii) The health care entity reasonably infers from the circumstances, based on the exercise of professional judgment, that the patient does not object to the disclosure. (b) If the patient is not present or the opportunity to agree or object to the disclosure of information cannot practicably be provided because of the patient's incapacity or an emergency circumstance, the health care entity may disclose the information if the entity determines that the disclosure of the information is in the best interests of the patient. In determining whether the disclosure of information is in the best interests of the patient, in addition to all other relevant factors, the health care entity shall consider all of the following: (i) The patient's medical and treatment history, including the patient's history of compliance or noncompliance with an established treatment plan based on information in the patient's medical record and on reliable and relevant information received from the patient's family members, friends or others involved in the patient's care, treatment or supervision. (ii) Whether the information is necessary or, based on professional judgment, would be useful in assisting the patient in complying with the care, treatment or supervision prescribed in the patient's treatment plan. (iii) Whether the health care entity has reasonable grounds to believe that the release of the information may subject the patient to domestic violence, abuse or endangerment by family members, friends or other persons involved in the patient's care, treatment or supervision. (c) The health care entity believes the patient presents a serious and imminent threat to the health or safety of the patient or others, and the health care entity believes that family members, friends or others involved in the patient's care, treatment or supervision can help to prevent the threat. (d) In order for the health care entity to notify a family member, friend or other person involved in the patient's care, treatment or supervision of the patient's location, general condition or death. 8. A state agency that licenses health professionals pursuant to title 32, chapter 13, 15, 17, 19.1 or 33 and that requires these records in the course of investigating complaints of professional negligence, incompetence or lack of clinical judgment. 9. A state or federal agency that licenses health care providers. 10. A governmental agency or a competent professional, as defined in section 36-3701, in order to comply with chapter 37 of this title. 11. Independent oversight committees established pursuant to title 41, chapter 35. Any information released pursuant to this paragraph shall comply with the requirements of section 41-3804 and applicable federal law and shall be released without personally identifiable information unless the personally identifiable information is required for the official purposes of the independent oversight committee. Case information received by an independent oversight committee shall be maintained as confidential. For the purposes of this paragraph, "personally identifiable information" includes a person's name, address, date of birth, social security number, tribal enrollment number, telephone or telefacsimile number, driver license number, places of employment, school identification number and military identification number or any other distinguishing characteristic that tends to identify a particular person. 12. A patient or the patient's health care decision maker. 13. The department of public safety or another law enforcement agency by the court to comply with the requirements of section 36-540, subsections O and P. 14. A third-party payor or the payor's contractor as permitted by the health insurance portability and accountability act privacy standards, 45 Code of Federal Regulations part 160 and part 164, subpart E. 15. A private entity that accredits the health care provider and with whom the health care provider has an agreement requiring the agency to protect the confidentiality of patient information. 16. The legal representative of a health care entity in possession of the record for the purpose of securing legal advice. 17. A person or entity as otherwise required by state or federal law. 18. A person or entity as permitted by the federal regulations on alcohol and drug abuse treatment (42 Code of Federal Regulations part 2). 19. A person or entity to conduct utilization review, peer review and quality assurance pursuant to section 36-441, 36-445, 36-2402 or 36-2917. 20. A person maintaining health statistics for public health purposes as authorized by law. 21. A grand jury as directed by subpoena. 22. A person or entity that provides services to the patient's health care provider, as defined in section 12-2291, and with whom the health care provider has a business associate agreement that requires the person or entity to protect the confidentiality of patient information as required by the health insurance portability and accountability act privacy standards (45 Code of Federal Regulations part 164, subpart E). 23. A county medical examiner or an alternate medical examiner directing an investigation into the circumstances surrounding a death pursuant to section 11-593. B. Information disclosed pursuant to subsection A, paragraph 7 of this section may include only information that is directly relevant to the person's involvement with the patient's health care or payment related to the patient's health care. Subsection A, paragraph 7 of this section does not prevent a health care entity from obtaining or receiving information about the patient from a family member, friend or other person involved in the patient's care, treatment or supervision. A health care entity shall keep a record of the name and contact information of any person to whom any patient information is released pursuant to subsection A, paragraph 7 of this section. A decision to release or withhold information pursuant subsection A, paragraph 7 of this section is subject to review pursuant to section 36-517.01. C. Information and records obtained in the course of evaluation, examination or treatment and submitted in any court proceeding pursuant to this chapter or title 14, chapter 5 are confidential and are not public records unless the hearing requirements of this chapter or title 14, chapter 5 require a different procedure. Information and records that are obtained pursuant to this section and submitted in a court proceeding pursuant to title 14, chapter 5 and that are not clearly identified by the parties as confidential and segregated from nonconfidential information and records are considered public records. D. Notwithstanding subsections A, B and C of this section, the legal representative of a patient who is the subject of a proceeding conducted pursuant to this chapter and title 14, chapter 5 has access to the patient's information and records in the possession of a health care entity or filed with the court. E. A health care entity that acts in good faith under this article is not liable for damages in any civil action for the disclosure of records or payment records that is made pursuant to this article or as otherwise provided by law. The health care entity is presumed to have acted in good faith. This presumption may be rebutted by clear and convincing evidence. F. For the purposes of this section, "information" means records and the information contained in records. 36-509.01. Case records; involuntary treatment hearings; confidentiality; definition A. Except as otherwise provided by law, court rule or court order, the case records of and case information regarding a court proceeding brought under article 4 or 5 of this chapter are not open to public access or inspection. B. The court, for good cause shown, may authorize the release of case records and case information regarding a court proceeding brought under article 4 or 5 of this chapter. C. The supreme court may adopt appropriate rules to govern the access to the case records and case information regarding any court action or proceeding brought under article 4 or 5 of this chapter. D. For the purposes of this section, "case record" has the same meaning as prescribed in rules of the supreme court. 36-510. Patient's compensation for work If a patient of a mental health treatment agency works, this work shall be in the patient's interest. If the primary purpose of this work is to benefit the mental health treatment agency or any agency of the state, the patient shall be employed and paid in accordance with law. If the purpose of the work is therapeutic, the patient may or may not be paid as circumstances indicate. This therapeutic work shall be part of a planned program of treatment described in the patient's record with the rationale for the work-treatment included. It shall be periodically reviewed by the appropriate agency review procedures. The term "work" does not mean matters of personal housekeeping or personal maintenance. 36-510.01. Notice; personal service of process A. A person who is ordered to undergo involuntary evaluation has the right to receive by personal service the documents specified in section 36-529, subsection E. A person who is the subject of a petition for court-ordered treatment has the right to receive by personal service the documents specified in section 36-536, subsection D. Personal service shall be completed by a peace officer or a process server or by another person as prescribed by law or court rule or as ordered by the court, personally handing the documents to the person receiving service. The person who serves the specified documents must file a proof of service with the court that specifies the date, time and manner of service. B. In a proceeding under this chapter involving a petition for court-ordered evaluation or court-ordered treatment, if the proposed patient is admitted to a facility that is licensed as a screening agency or an evaluation agency pursuant to this chapter at the time the petition is filed, the court may authorize a person employed by the screening agency or evaluation agency to serve the documents specified in section 36-529, subsection E or section 36-536, subsection D, as applicable, on the proposed patient. C. A county, city or town that employs peace officers may contract with a process server, a screening agency or an evaluation agency to provide service pursuant to this section instead of service by a peace officer. D. An evaluation agency or screening agency is not financially responsible under subsection A of this section for serving the documents required by section 36-529, subsection E or section 36-536, subsection D. E. An evaluation agency or screening agency may only receive reimbursement for the service of documents under subsection B of this section pursuant to a contract with a county. 36-511. Quality of treatment A. Subject to the right to refuse psychiatric and medical treatment pursuant to sections 36-512 and 36-513 and pursuant to rules of the administration, every person undergoing evaluation or treatment pursuant to this chapter shall receive physical and psychiatric care and treatment, delivered in a manner that allows the person's family members or guardian to participate in the care and treatment when appropriate, for the full period the person is detained. The agency providing care and treatment shall keep a clinical record for each person that details all medical and psychiatric evaluations and all care and treatment received by the person. B. An agency administering the care and treatment shall provide and make available to the guardian, if one exists, on request: 1. A written treatment program based on the individual needs of the person. 2. Careful and periodic reexaminations of each person by appropriate professional persons, including a physician. Reexaminations shall be made once each ninety days, and the results shall be a part of the person's medical record. 3. A full physical examination once a year. 4. Adequate medical treatment in the light of present medical knowledge in accordance with the results of these examinations. C. An agency administering inpatient care and treatment, in conjunction with the community treatment agency and before the release of a patient, shall prepare a plan for the patient's care after release, including arrangements for a place to live and an adequate program for necessary treatment and maintenance, and shall provide the plan to the patient's guardian if one exists. The community treatment agency shall make a good faith effort to initiate treatment with a patient released from an inpatient facility. 36-512. Emergency medical care A person undergoing evaluation or treatment has a right to refuse any and all medical treatment unless ordered by the court, except that when, in the written opinion of the attending physician, a true medical emergency exists and medical care and treatment including surgical procedures are necessary to save the life, physical health, eyesight, hearing or member of the person, the medical director of the agency may give consent to such medical care and treatment if time will not permit the obtaining of appropriate judicial authority. The patient's guardian, if one exists, shall be notified by the medical director of the giving of emergency medical care immediately. 36-513. Seclusion; restraint; treatment A person undergoing evaluation pursuant to article 4 of this chapter shall not be treated for his mental disorder unless he consents to such treatment, except that seclusion and mechanical or pharmacological restraints may be employed in the case of emergency for the safety of the person or others. A person undergoing treatment pursuant to article 5 of this chapter shall not be subjected to seclusion or mechanical or pharmacological restraints except in case of emergency for the safety of the person or others or as a part of a written plan for the treatment of the patient, prepared by staff members responsible for his care and pursuant to regulations promulgated by the department. All instances of seclusion or restraint shall be properly recorded in the patient's medical record and the use shall be governed by written procedures of the agency caring for the patient and are subject to the rules and regulations of the department. 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. 36-515. Limitation of liability; false application; classification A. Any person acting in good faith upon either actual knowledge or reliable information who makes application for evaluation or treatment of another person pursuant to this chapter is not subject to civil or criminal liability for such act. B. Any person who knowingly makes a false statement of a material fact with the intent to cause another to be confined under this chapter is guilty of a class 1 misdemeanor. 36-516. Violation of person's rights Any knowing violation of a person's rights under this article shall give him a cause of action for the greater of either one thousand dollars or three times the actual amount of damages. It is not a prerequisite to this action that the plaintiff suffer or be threatened with actual damages. 36-517. Cruelty to mentally disordered person; classification A person guilty of any harsh or cruel treatment of, or any neglect of duty toward a mentally disordered person is guilty of a class 2 misdemeanor. 36-517.01. Review of decisions regarding release of treatment information; notice; appeal; immunity A. An agency providing evaluation or treatment, on request of a person undergoing evaluation or treatment, a member of his family or his guardian, shall review the treating professional's decision to release or withhold information requested pursuant to section 36-504, subsection B or section 36-509, subsection A, paragraph 7. The agency shall inform a person whose request is denied of his right to a review when it notifies that person of its decision. The agency director or his designee shall conduct the review within five business days after the request for review is made. The review shall include an interview of the person undergoing evaluation or treatment. The agency shall make a decision to uphold or reverse the treating professional's decision within five business days after initiating the review. The agency shall bear the costs of conducting the review. Agency review pursuant to this section does not apply to a decision to release or withhold information made by a nonagency treating professional. B. A final agency decision made pursuant to su