Archive for the ‘Licensing’ category

Rulemaking Stuff

May 10th, 2013

Our Licensing and Rulemaking teams spent the last week of April with hundreds of Stakeholders from numerous associations and licensees about our ongoing regulatory reform effort.  In addition, we’ve received hundreds of comments regarding our draft rules for Healthcare Institutions and Behavioral Health Service Agencies on our website (the comment period ended on May 5).  Our teams are now busy going through the written comments and our notes from the meetings as we prepare the final regulations, which are due by the end of June. 

We also have another Midwifery Scope of Practice Advisory Committee meeting on Wednesday, May 15 from 4-6 pm in the Lab.  We’ll be discussing the newest edition of the draft rules.  The latest draft still includes Vaginal Birth After Cesarean (VBAC) and Breech Delivery as within scope for Certified Professional Midwives under certain prescribed circumstances, although this latest version would not allow for the delivery of twins by a midwife.  We’ve also clarified monitoring reporting requirements regarding labor progression.  The final midwifery rules are also due at the end of June.

 

Licensing’s Stakeholder Cornucopia

April 29th, 2013

Our Licensing and Rulemaking teams spent virtually all week hearing from hundreds of Stakeholders from numerous associations and licensees about our ongoing regulatory reform effort.  Our team met with representatives from:  Adult Day Health Care Facilities;  Assisted Living FacilitiesHome Health Agencies; Hospices; Hospitals; Nursing Care Institutions; Outpatient Surgical Centers; Outpatient Treatment Centers; Recovery Care Centers; Adult Therapeutic Foster Homes; DUI Services; Level 1 Residential Treatment CentersLevel 1 Sub-Acute Facilities; Level 3 BH Residential Agencies; Level 4 Transitional Agencies; and Rural Substance Abuse Transitional Agencies

Most of the meetings went fairly well, with representatives providing us with specific and mostly constructive feedback which we’ll use to help construct better regulations.  Some meetings were more helpful than others.  The meetings in which folks gave us specific and targeted feedback regarding discrete parts of our draft rules were, of course, the most productive. 

We’ve posted our draft rules for Healthcare Institutions and Behavioral Health Service Agencies on our website.  Folks can continue to provide written comments and feedback via the respective on-line surveys on the Healthcare Institutions and Behavioral Health Service Agencies websites through May 5.

 

Programs that Advance Health Equity

April 25th, 2013

If you live in or have visited the rural towns and cities in Arizona, it’s not a surprise that many of these rural locations don’t have enough healthcare providers. Based on current provider shortage data from the federal HRSA, we need an additional 170 primary care providers and 54 mental health providers to adequately care for its underserved populations. 

April is Minority Health Month and a great time to highlight one of our programs that addresses provider shortages and improves health equity in rural and underserved areas. The First Things First Early Childhood Therapist Incentives Program provides stipends and loan repayment to Speech & Language Pathologists, Occupational and Physical Therapists, Child Psychologists, and Mental Health Specialists who provide early childhood development services in rural and underserved areas.  

The program currently has 30 providers participating and will be accepting applications until June 15 for providers in 9 rural counties.  Visit the First Things First Early Childhood Therapist Incentives Program for eligibility and application details.  This program is one of several incentives that can help bring more providers to undeserved areas of the state. Visit the workforce programs web site for information on other programs.

Empower Conference

April 18th, 2013

Our Empower program is hosting its second annual conference Empowering Habits, Empowering Lives: Super Heroes in Action on May 4.  The conference is a great opportunity for providers in Early Care and Education settings to learn the new 10 Empower standards that have been established for 2013.  The conference sessions will also equip participants with the resources and tools essential to implement the 10 standards, thus transforming them into super heroes in action!  Check out the conference flyer for more details.

 

Licensing Changes Near

April 9th, 2013

We’re getting near the end of the long journey of our licensing regulatory reform.  Last Wednesday we posted the revised draft rules for Chapter 10 (Health Care Institutions – Licensing) and Chapter 20 (Non-licensing approval).  Our goals is to simplify and streamline our rules so they align with our strategic plan and map to improve public health outcomes.  We’ve been working with representatives from the medical community, the behavioral health system, advocates and other affected folks to help reform our regulations.  We still need your help. Please provide comments for Chapter 10 using online surveys . Please provide comments for Chapter 20 using online survey .

The comment period will end on May 5th. The Department will revise the drafts and the final rules will take effect on July 1st of this year.  Please visit our Licensing webpage  to learn more about our integrated licensing rules implementation.

Thanks to all who have helped to advance the licensing of integrated health in Arizona!

Tonight’s Midwifery Scope of Practice Meeting

April 3rd, 2013

Our Midwifery Scope of Practice Advisory Committee Meeting is meeting from 4 to 6 pm this evening in the Lab conference room (250 N 17 Avenue, Phoenix).  The Agenda includes a discussion of the draft U of A Literature Review including a Presentation of the results along with the  Draft Rules for Public Comment.  The meeting will be broadcast live on Livestream and we’ll have an opportunity for folks to follow the conversation on Twitter with #azmidwives.

 

Licensing’s “ADVICE Collaborative”

March 28th, 2013

Our Licensing team routinely analyzes the most frequent and important deficiencies that we observe and posts the data on our website.  We use the data to help educate the folks that we license… and to identify good topics for provider training and technical assistance (public health interventions).  For example, our medical facilities licensing team has found that infection control is becoming increasingly troublesome among some dialysis providers. 

That info led our medical facilities licensing team to join with our Office of Infectious Disease Services and the ADHS Healthcare Associated Infections Advisory Committee to plan and provide a day-long collaboration to our licensed dialysis providers and public health professionals. This collaborative- (known as the ADVICE collaborative – Arizona Developing Value through Innovation and Communication) will provide tools for dialysis providers to improve their infection control performance by building relationships with public health, renal associations, federal partners and other stakeholders. 

The day will be spent sharing best practices, identifying new ways to promote infection control, and developing a strategic plan for future activities. We’ll also be passing on what we learn to our Healthcare Associated Infection Advisory Committee so they can develop and produce trainings and resources that will improve infection control.  You can find out more about the collaborative by visiting our website. This is just one of our many examples of how we’re leveraging licensing to improve public health outcomes.

April Midwifery Scope of Practice Meeting

March 22nd, 2013

The next meeting of the Midwifery Scope of Practice Advisory Committee will be from 4:00 p.m. to 6:00 p.m. on Wednesday April 3, 2013 at the State Laboratory Conference Room located at 250 N. 17th Avenue in Phoenix.   Here’s the agenda for the meeting.  Our Rules team is still working on the set of draft rules that we’ll be discussing at the April 3 meeting.  We expect the next iteration of the straw draft rules to be posted on our rules website by close of business on March 27.

Those of you that have been following the developments of our regulatory reform effort for our licensed midwives know that we’re in a kind of transition period.  While we won’t be finished with our regulatory reform rules package for midwife licensing until the end of June…  we still need to make sure that we’re administering our current regulations as efficiently as possible.

Our midwife licensing team recently noticed that the midwife quarterly reports have been submitted using as  many as 3 different forms.  Last week our team sent out the appropriate current quarterly reporting form to be sure that we’re getting the right information under the current regulations.   I think there’s been some confusion among the folks that got the form last week.  To be clear…  the form that our team sent out last week is the current quarterly report form- not the reporting requirement that will ultimately be required under our future rules (the new reporting will be 100% electronic). 

Also, the requirement in the current form for documentation of medical backup is a current requirement.  Whether or not we continue to require that kind of documentation hasn’t been determined yet- but the draft rules that we have discussed this far don’t include that specific requirement.  We regret any confusion or concern that the updated form may have raised.

Hitting Our Mark at Showtime

February 28th, 2013

Last Saturday our Licensing team hit the mark at Showtime- when it matters most.  After hearing that the Fountain Retirement Hotel had put residents on notice it was closing, we immediately became concerned that staff would stop showing up, food and medication would not be given out, and the residents would be turned out into the streets to live. Many of the residents have significant medical and behavioral health needs, and need a caregiver to assist them with things like taking medication and preparing food.  

Our licensing team arrived at the facility immediately after hearing of the situation from the Sheriff’s Office…  and our licensing team pretty much right away called an “immediate jeopardy” (meaning that there was the potential for a real threat to health and safety of the residents).  Our team stayed all afternoon and into the night, working with the facility’s owner and manager to ensure all residents would be safe.  We maintained a strong presence at the facility throughout the weekend, making sure there were proper caregivers, enough food, and that residents were receiving their medication. 

We’re still sending surveyors out twice a day and are working with many other agencies, including AHCCCS, the VA, Adult Protective Services, Magellan, Partners in Recovery, and the Long Term Care Ombudsman’s Program to make sure the residents are finding new homes that will be able to meet their needs.  A huge thanks to Dr. Cara Christ, Kathy McCanna, Richard Young, Ellie Strang, and Jim Tiffany, for responding so effectively and ensuring the Health and Wellness of these Arizonans.  Thanks!

Helping Kids Recover

February 26th, 2013

Our Vision at the Arizona Department of Health Services is, ”Health and Wellness for all Arizonans.”  Part of our mission includes helping individuals with substance abuse issues achieve and maintain self-reliance and independence.  To get there, some individuals simply need occasional outpatient services.  Some need wrap-around, community or home-based services.  Others require more intensive treatment in a residential setting.  Our goal is to provide the most effective kind of treatment to suit every individual’s unique needs. While no two paths to recovery will ever be identical, we do know this: young people recover better in settings as close to home as possible. 

Over the past two years, we’ve taken that knowledge to heart – and our actions have paid dividends. We’re matching more people with effective wrap-around services like in-home counseling, high-needs case management, home-care training, peer support, respite, family support and skills training.  In turn, we’ve reduced the need for care in licensed high-level Residential facilities by 75% in Maricopa County. However, outpatient treatment, home and community-based services can’t always provide the level of treatment people need.  Some individuals require more intensive treatment that only a licensed and regulated residential facility can provide.  

A series of reports in The Republic this week suggests that some juvenile residential treatment facilities in our state are substandard.  While no facility is perfect, our inspectors are well-trained and highly-motivated to ensure each of our licensed residential treatment facilities meets State standards. Those that fail to meet these standards must implement an immediate corrective action plan. 

We inspect residential treatment facilities at least once a year — more often when we receive complaints. When we inspect facilities, our teams make decisions based on evidence. We talk to the residents and the staff; we look at patient and personnel records (including video records); we observe facility practices and examine physical evidence. This helps us separate legitimate complaints and concerns from those that are baseless or intentionally fabricated.  We receive dozens of incident reports every day, which we carefully and promptly evaluate. It’s unusual that a report poses a health or safety problem. But when a situation that does is brought to our attention, we immediately send staff to the facility. 

Successful residential treatment facilities are pro-active, follow their policies and procedures without fail, are meticulous in reporting and documentation and seek ongoing education. They’re not afraid to admit a mistake. Our job is to ensure that facilities comply with our standards and maximize their effectiveness. That’s why our licensing teams also focus on ways to improve our licensed facilities and our Behavioral Health team focuses on the evidence-based treatment that’s best for the patient. Additionally, we’ve been overhauling many regulations to ensure our standards focus on the most important components of care. 

Our actions as an agency must be based in fact and rooted in the evidence demonstrated by a comprehensive review of the facility in question. You can view factual information about the more than 7,400 facilities we license by visiting www.azcarecheck.com.