Arizona Considers New Licensing Requirements for Care Facilities

New legislation could be on the way to regulate facilities in Arizona that provide care to people with developmental disabilities. Per a report from the Associated Press, Arizona Governor Doug Ducey recently issued an executive order instructing state agencies to ramp up protections for individuals with disabilities.

The order, if approved by the legislature, will add new licensing requirements for “intermediate care facilities.” Medicaid classifies intermediate care facilities as “facilities for individuals with intellectual disability…that enables states to provide comprehensive and individualized health care and rehabilitation services to promote their functional status and independence.” These facilities are considered an “optional Medicaid benefit.”

Right now, intermediate care facilities for citizens with developmental disabilities are mostly exempt from state regulation. The system dates to the 1990s when Arizona rolled back state regulations for these facilities and handed regulation off to the federal government—specifically, the Centers for Medicare and Medicaid Services. The government later contracted the state to handle some of the regulation of the facilities, including inspections roughly every year.

The state currently has no power to penalize these facilities for any safety violations or to enforce any federal regulations on its own.

The renewed interest in the regulation of Arizona’s intermediate care facilities relates to an incident that occurred at a Phoenix facility. In December, a 29-year-old patient at Phoenix’s Hacienda Healthcare gave birth to a baby boy. The woman had been a patient at the facility since she was three years old for a seizure disorder. Court documents have noted that she is incapacitated and non-verbal. Caregivers were unaware she was pregnant. A DNA test later revealed that the baby boy’s father was Nathan Sutherland, a 36-year-old nurse at the facility. Sutherland is facing charges of sexual abuse for rape.

Governor Ducey’s executive order would require facilities such as Hacienda Healthcare to apply for state licensure. Other facilities that care for vulnerable populations, such as nursing homes or assisted living centers, must be licensed—but facilities such as Hacienda, which operate as intermediate care facilities, do not have to obtain state licenses.

In addition to licensing requirements, Ducey’s bill demands background checks for any employees whose jobs involve working with patients. These checks will include criminal screening and searches of abuse and neglect registries. For state-funded facilities, the governor wants annual training requirements for employees with a focus on helping those employees recognize, report, and prevent abuse or neglect.

Many of the people who work in facilities such as Hacienda already go through background checks at the state level despite the lack of licensure requirements for the facility. As nurses, doctors, or other healthcare professionals, these individuals must be licensed by the state nursing or medical boards, which require background checks as part of the licensing process. However, intermediate care facilities are not required to do their own background checks. As a result, employees who aren’t required to hold any form of license may never go through a background check before working at these facilities.

Ducey’s executive order would effectively close this loophole.