Maricopa County Special Health Care District v. Jackson

Arizona Court of Appeals, Division One

August 7, 2025

JSH Attorney:  Rita Bustos

The Arizona Court of Appeals has ruled that special health care districts can be sued under the Adult Protective Services Act (APSA), providing important clarification following the Arizona Supreme Court’s decision in Estate of Braden ex rel. Gabadon v. State, 228 Ariz. 323 (2011).  In this case, Peggy Jackson filed a notice of claim against Valleywise and Maricopa County, citing gross medical negligence.  She later initiated a lawsuit for medical negligence and negligent infliction of emotional distress.  Later, Jackson sought to amend her complaint to include a claim under the Adult Protective Services Act (APSA), asserting that Valleywise’s conduct constituted abuse or neglect of a vulnerable adult.  The trial court allowed the amendment and denied Valleywise’s motion to dismiss the APSA claim, prompting Valleywise to seek special action relief from the Court of Appeals.

The Arizona Court of Appeals accepted jurisdiction due to the legal novelty and statewide importance of the issue—whether a special health care district is subject to suit under APSA.  The Court ultimately rejected Valleywise’s argument that it could not be sued under APSA as a political subdivision, emphasizing that Arizona Revised Statutes § 48-5541(2) explicitly provides that special health care districts may “be sued in all courts and places and in all actions and proceedings.” The Court found this language clear and unambiguous— “all” means all.  Additionally, the Court determined that special health care districts qualify as “enterprises” under APSA because they function as municipal corporations, engage in commercial activities competing directly with private hospitals, and operate more like business entities than traditional government agencies.

Importantly, the Court distinguished this case from Estate of Braden, noting that the earlier decision involved the State of Arizona itself, not a political subdivision, and that the Arizona Supreme Court in Braden acknowledged that the definition of “enterprise” could embrace both private and public entities.

The Court also found that Jackson’s notice of claim met statutory requirements.  Although it did not reference APSA directly, it provided sufficient factual detail to allow Valleywise to investigate potential liability under APSA.  The claim described Heinreich’s vulnerability, the injuries he sustained, the alleged neglect in medication management, and Valleywise’s role as caregiver—all elements necessary to support an APSA claim.

This decision has significant implications for political subdivisions providing healthcare services, as they should now expect potential APSA liability and ensure their risk management includes APSA compliance considerations.  The reasoning in this case could potentially extend to other political subdivisions engaged in healthcare or elder care services, making this a precedent that political subdivisions should carefully evaluate.

Rita Bustos is a partner in the firm’s appellate practice group. She has over 15 years of appellate experience with a particular emphasis on medical malpractice and healthcare defense. In addition to her appellate practice, Rita works closely with trial counsel to provide guidance from the pleading stage through the trial, including drafting complex motions, and the post-trial stages in state and federal courts.

rbustos@jshfirm.com | 602.263.1715 | jshfirm.com/rbustos