Posts Tagged ‘behavioral health facilities’

Evidence-Based Decision-Making: A Key Regulatory Benchmark

November 19th, 2012

The role of a surveyor can be a difficult one. Our team of licensing surveyors need to maintain neutrality as regulators and be able to apply the Arizona Administrative Code (otherwise known as “the rules”) to a wide variety of facilities within the healthcare system.  Part of our surveillance includes investigating complaints- which can be generated from an array of internal and external sources.  When the complaints come because of TV or other media coverage- it can pose unique challenges for our team.  But…  no matter where the complaint comes from, our job is to use facts and evidence to drive our investigation, decision-making, and interventions. 

There are 3 forms of evidence that we use to substantiate an allegation made in a complaint: 1) observation; 2) documentation; and 3) interviews. Two of these forms of evidence need to be present before we find that a complaint is “substantiated”.  By using these tried and true evidence-based tools we put ourselves in the best position to identify real health and safety problems without jumping to conclusions.

Focusing on facts and evidence (and not allowing one’s self to be driven by media coverage) is a good start…  but there are a few things that both surveyors and healthcare professionals can do to keep focus on providing a healthy and safe environment. Keep good records, document, sign and store up to date data, maintain consistent supervision for those that require it, follow your agency’s policies and procedures without fail, report what’s required, be proactive (not reactive), and seek out ongoing education in your field.  Don’t cut corners when it comes to care… and don’t be afraid to admit a mistake or that you do not have all the answers. 

So, if you happen to hear or see a TV story about a facility, keep in perspective that the story might focus on anecdotes and what the reporter thinks they know or even just their opinion- not necessarily what the evidence demonstrates.  In a time when information is disseminated second by second rather than day by day, let’s remember that we all share the same goal, to promote Health and Wellness for all Arizonans, which includes providing surveyors, community, clients and staff accurate and factual information.

Curious about the real scoop on how all of our licensed facilities are doing?  Check out our AZ Care Check website which has the details about our evidence-based investigations and surveys.

Behavioral Health Licensing Rulemaking Update

May 31st, 2012

As I’ve mentioned in previous posts- we’re in the beginning phases of overhauling our regulations for licensing behavioral health facilities.  This’ll be a long process- and the finish line is in mid-2013.  We’re starting with a set of what we’ll call “straw-man” language that we can use as a way to start the discussions.  We’ve delivered the initial language for inpatient facilities already- and we’re working with stakeholders on the initial language for residential now and we’ll be doing the out-patient later this fall.  

The “official” part of the process in early 2013 with the publication of the full set of Notice of Proposed Draft Rules which will go out for public comment early next year.  We’ll then incorporate good suggestions from the draft into the Notice of Final Rules, which will go out for public comment in the Spring of 2013.  The goal is to have the final rules in place by July 2013. 

So…  there’s lots of time to get involved.  I’ve heard anecdotal stories of folks that think our “straw-man” language is set in stone- it’s not at all!  You can really think of the initial language as spring training in an 162 game baseball season.  You can save our Behavioral Health Rulemaking URL in your “Favorites”.  The rulemaking is an iterative process- and you can provide feedback via survey monkey from the Rulemaking website…  as we constantly use the input as we work through the process.

Providing Transparent Inspection Results is a Key to Effective Compliance

June 29th, 2011

Our Division of Licensing Services monitors a wide range of facilities including hospitals, assisted living and skilled nursing centers, behavioral health facilities, child care facilities, and group homes for folks with developmental disabilities.  Our teams of surveyors conduct inspections, on-site surveys, and complaint investigations to make sure all of our licensed facilities promote quality care and safety and meet their performance standards.  Our goal is always to gain compliance without having to resort to enforcement actions as I described in a blog post a few months ago.

One of the tools we use to make sure they meet our health and safety expectations is to provide the public with easy to access information about each and every facility’s inspection results.  That way, the public can decide for themselves whether they want to use the services of a licensed facility.  This brings the consumer into the mix and helps us with our mission.  That’s why we developed our electronic tool we call AZ Care Check.  It provides the consumer an easy-to-use tool that allows them to look up the compliance history of any of our licensed facilities, allowing them to make informed decisions about where to seek services for themselves or their loved-ones and how to spend their money.

Adjusting Licensing to Accommodate Integration

April 13th, 2011

I’ve written often over the last few weeks about our priority over the next couple of years to better integrate primary healthcare and psychiatric care in AZ, and that last week HHS approved the Health Homes Planning Grant which will focus on improving coordination of care and increasing access to primary care and prevention services, resulting in meaningful improvements in quality of life and health status.

Making integration happen effectively will take coordination among numerous parts of the Department (much like the work that was required for medical marijuana).  We’ll need to coordinate updated IT and business needs as well as public health prevention and licensing, and of course behavioral health.  Licensing will be an especially important partner because our medical and behavioral health licensing teams inspect AZ treatment facilities.

One of the challenges that we’ve been facing as we begin our integration efforts is that the licensing rules for medical and behavioral health facilities sometimes make integration more difficult than it needs to be, and one of our goals over the coming months is to overhaul our administrative code (rules) for behavioral health facilities.    In the mean time, our offices of Medical and Behavioral Health Licensing has been working very closely with a number of our service providers in the central, eastern and southern areas of the state to ease the licensing process as Arizona embraces integrative health care. Presently, there are a series of projects under construction that we anticipate will be looking to license this summer.

As part of our overall planning for the implementation of integrative health care, we’ve been connecting with prospective licensees to provide technical assistance, concentrating on architectural requirements and rule and service delivery. By taking a proactive stance with licensees, we can cut down on additional visits to the site to navigate compliance at a later date. That way, providers can start meeting the needs of their community in underserved areas.