Posts Tagged ‘Arnold v. Sarn’

Behavioral Health Services in Maricopa County

June 12th, 2011

We recently extended our contract with the Regional Behavioral Health Authority in Maricopa County through September 30, 2013.  We authorized the contract extension (which will be the 6th year of the contract) so that we can better serve our members and families while we hammer out the details of several new initiatives designed to improve the quality of the services that we provide in the behavioral health system.  Several large-scale initiatives are just getting underway and we have important details to iron out before we put out the next contract Request For Proposal (technically called the Maricopa County RFP).

For example, you’ve heard me talking about our commitment to improve health and wellness for folks with serious mental illnesses by better integrating psychiatric and physical healthcare.  To move forward, we’ve (ADHS and AHCCCS) applied for and received a Health Homes Planning Grant to plan for implementation of health homes for adults with serious mental illness.  There’ll undoubtedly need to be significant changes to the RFP based on the outcomes of this work, and this extra year will give us an opportunity to include results of the planning grant in that next RFP.

In addition, because of the current (and continuing) budget crisis, the parties in Arnold v. Sarn agreed to stay the court orders until June 30, 2012.  During the stay, we all agreed to negotiate revised court orders.  Over the past several months, we’ve been conducting dozens of focus groups with adults with serious mental illness to help inform and set priorities for the new court orders.  Our negotiations will take place this summer and they’ll most likely continue into 2012.  The framework for the new court orders will also help shape the language in the new RFP.  Lastly, there are some significant Medicaid reforms proposed (or already being implemented) for Arizona, as outlined in the Fiscal Year 12 budget that will potentially have an impact for the next RFP.

The bottom line is that this extension will allow us to issue a thorough, well-researched and comprehensive RFP so we can achieve our ultimate performance objectives of integrating care and incorporating new court orders while maintaining continuity of care and preventing a disruption in services. The agreement we signed outlines other initiatives impacting this decision to extend the current contract and indicates that we’ll be carefully evaluating the progress on the Health Homes Planning Grant.

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Raise Your Voice, Arizona!

November 12th, 2010

If you or one of your family members receives behavioral health services in Arizona, it’s time to raise your voice and be heard.  Over the next few weeks our ADHS Behavioral Health System Transformation Team will be sponsoring a series of forums so that folks can express their opinions about how we should shape the future of behavioral health system in Arizona.  The forums will actively involve the community through a series of focus groups that’ll gather the collective opinion of members on what they want and need from the behavioral health system.  The team will be using an evidence-based practice called Community Based Participatory Research- which is used in public health research to engage the community in designing programs that are responsive to the public’s needs.  Using this approach, we’ll be able to build a sense of shared responsibility, ownership and buy-in for system redesign.

We’ll have 14 focus groups throughout Maricopa County and 6 others statewide over the next few weeks.  Peers and family members have volunteered and have been trained to assist in the facilitation of the focus groups.  Each focus group will be conducted using a script of instructions and questions which were developed with peer and family member input.  Each group will be divided into smaller groups of four to eight participants to discuss each question.  The consensus answers will be recorded on sheets of easel paper and collected at the conclusion of the meetings.  The data we collect at the forums will be entered into a database and analyzed for themes, trends and issues using an SPSS (Statistical Package for the Social Sciences) software program.

Our objective is develop a report of the findings to help us transform the system.  We’ll also use the information as a first step toward developing draft new court orders under the Arnold v. Sarn court case.   After we see the results from the focus groups, we can determine next steps.  Information about the forums is posted on our BHS Transformation Page and our Department Homepage.  Thanks to Teresita Oaks, Claudia Sloan, Stacy Mobbs, Robert Sorce & Team DBHS for your work on this initiative!

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Arnold v. Sarn Stipulation Agreement

March 16th, 2010


I haven’t written much about the Arnold v. Sarn lawsuit because its so complicated and difficult to explain. Basically, it’s a lawsuit filed against ADHS in 1981 (adding the Governor as a defendant in 2000) that has held the Department accountable to certain court orders about community-based behavioral health services for adults with serious mental illness in Maricopa County.  This week there was a major event in the history of this decades-long case.  The Plaintiffs and Defendants entered into a joint stipulation agreement that suspends many aspects of the case through 2012 as a result of the budget crisis.

This week Judge O’Connor signed a court order approving a ”Joint Stipulation to Stay Litigation During Fiscal Budget Crisis”.  The Stipulation essentially:

  1. Puts a “hold” on litigation and enforcement of all current Court Orders through June 30, 2012, including the Appointment Order for the Court Monitor, enforcement, monitoring and compliance activity;
  2. Suspends some of the requirements in Article 3 of the Serious Mental Illness Rules (Title 9, Chapter 21, Article 3 of the Arizona Administrative Code) to the extent that compliance with those rules is impacted by the budget crisis.  This section of the Rules addresses assessments and service planning and can be found at http://www.azsos.gov/public_services/Title_09/9-21.htm.;
  3. Requires the Defendants to use their best efforts to serve the class members with all available resources during the time period of this stay;
  4. Requires the parties to, in good faith, revisit and revise the Court Orders with consideration for funding, defining  terms and conditions regarding the potential use of a Court monitor in the future, and redefine the services, supports, and benefits that must be provided.

    We’re optimistic that revised Court Orders will focus on outcome based objectives that are measurable and more consistent with Recovery.  Our entire team will remain committed to maintaining the best possible service delivery and service quality that we can with the resources and funding that we have…. and we’ll maintain our intensive oversight and monitoring of our behavioral health contractors.   We’ll continue to hold our tribal & regional behavioral health authorities accountable for the quality of services they provide and how public funds are used.  We’re working on bringing much more transparency to the behavioral health system (along the lines of the “dashboard”), so stakeholders can easily see for themselves how providers are performing….  and we’ll continue to promote recovery and consumer choice. (See ADHS letter to stakeholders.)

    The bottom line is that coming year is a crucial time for the behavioral health system in Arizona…  and we’re committed to ensuring that we do our very best to provide the highest quality of care that we can given our resources.

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