Arizona Administrative Code
Title 9 - HEALTH SERVICES
Chapter 21 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM (AHCCCS) BEHAVIORAL HEALTH SERVICES FOR PERSONS WITH SERIOUS MENTAL ILLNESS
Article 5 - COURT-ORDERED EVALUATION AND TREATMENT
Section R9-21-503 - Voluntary Admission for Evaluation

Universal Citation: AZ Admin Code R 9-21-503

Current through Register Vol. 30, No. 38, September 20, 2024

A. An application for voluntary evaluation pursuant to A.R.S. § 36-522 shall be submitted on AHCCCS form MH-103, Titled "Application for Voluntary Evaluation," set forth in Exhibit D to a mental health agency.

B. If a health plan receives an application according to subsection (A), the health plan shall provide for such evaluation under A.R.S. § 36-522 for any individual who:

1. Voluntarily makes application as provided in subsection (A);

2. Gives informed consent; and

3. Has not been adjudicated as an incapacitated person pursuant to A.R.S. Title 14, Chapter 5, or Title 36, Chapter 5.

C. Any mental health agency, which is not a health plan under R9-21-501, that receives an application for voluntary evaluation shall immediately refer the individual to:

1. The county responsible for voluntary evaluations; or

2. If the county has contracted with a health plan for voluntary evaluations, the appropriate health plan.

D. Any mental health agency providing voluntary evaluation services pursuant to this Article shall place in the medical record of the individual to be evaluated the following:

1. A completed copy of the application for voluntary treatment;

2. A completed informed consent form pursuant to R9-21-511; and

3. A written statement of the individual's present mental condition.

E. Voluntary evaluation shall proceed only after the individual to be evaluated has given informed consent on AHCCCS form MH-103 and received information that the patient-physician privilege does not apply and that the evaluation may result in a petition for the individual to undergo court-ordered treatment or for guardianship in the method prescribed by A.R.S. § 36-522.

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