There’s a well-known quote attributed to Abe Lincoln that goes something like this: “Give me 6 hours to chop down a tree and I will spend the first 4 sharpening the axe.”  Maybe somebody will someday quote me as saying:  ”Give us 20 months to transform the delivery of behavioral health and primary care services to address the health disparities among folks with a serious mental illness and we’ll spend the first half partnering with stakeholders“.  OK, we’ll probably never be quoted like that- but you get the idea.  The more up front work we do with our partners during our behavioral health system transformation- the more likely we’ll be successful in the end.

Community Based Research:  The last few months have been very busy as we’ve gathered Stakeholder input on the various moving pieces that fit into our overall behavioral health integration project.  We’ve had several meetings, focus groups, and forums lately on the concept of integrated primary and psychiatric care.  The first series of the focus groups were in the Fall of 2010 and were designed to gather input from peer and family members (the Raise Your Voice effort).  This Fall we and AHCCCS coordinated an RFI and had in-person meetings with companies the get input about the feasibility of the integration effort.  Throughout December, we pressed ahead with a series of stakeholder meetings from the behavioral health provider community.  Our Behavioral Health shop, AHCCCS and St. Luke’s Health Initiative sponsored and coordinated a series of focus groups over the last couple of weeks to gather input regarding integrating behavioral health and physical healthcare- and St. Luke’s Health Initiative will be busy over the next couple of weeks putting together the data- which we’ll use as we design and implement Health Homes for folks with a serious mental illness.  

Licensing Efforts:  Our Licensing and Rules teams also just finished a series of forums with behavioral health providers to gather input about how we should put together a rulemaking package that will put a regulatory structure regarding the quality of care that’ll set the stage for integrating behavioral health and primary acute care from a licensing standpoint. We’re excited about this rulemaking because it supports our efforts to establish coordination and collaboration between all behavioral health and physical health providers.

We’ve developed a preliminary plan to facilitate integration of behavioral and physical health services and the just completed forums included a presentation that included highlights about the statutory framework; preliminary integration plans for health care institutions and behavioral health services; and a brief outline of the rulemaking process including formation of workgroups. During the forums we received constructive feedback and lots of questions- and more than 200 folks attended.  The feedback received was encouraging. Questions from the audience included:  What is the timeline for completing the rulemaking? In a rural setting, is integration and co-location the same? What about respite care? Can I be in a workgroup? If we don’t integrate, will we lose our license? What about CSAs? If we are integrated, will we have two surveyors- one for BH and one for PH? What about DUI screening? Now that the licensing forums are completed, we’ll proceed with putting together a “straw man” set of rules- followed by some roll-up-the-sleeves work groups (including licensees) to help us assemble a draft rule package.

Summary: We’re committed to strengthening the recovery based foundation that characterizes Arizona’s behavioral health system using this 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.