Posts Tagged ‘behavioral health system’

Regulatory Reform Update

January 22nd, 2013

We’re continuing to make significant progress in our licensing regulatory reform efforts.  Our overall goal is to simplify and streamline our regulations so they align with our strategic plan and map to improve public health outcomes.  The new regulations will more acutely focus on health and safety criteria- and will put more emphasis on outcomes.  We’ve held numerous meetings with representatives from the medical community, the behavioral health system, advocates and other affected stakeholders to help us reform our regulations for Inpatient Behavioral Health Facilities, Residential Facilities, DUI Services, Domestic Violence Offender Treatment Programs, Outpatient Treatment Centers, Nursing Care Institutions, Assisted Living Facilities and Hospitals.  Public comments are being solicited through online surveys.  

In all, 18 Articles of regulations are being overhauled.  Draft Articles and online surveys can be found at the Health Care Institution and Behavioral Health Service Agency webpages.  By April 1st final drafts will be posted on our website for another round of comments.  The completed rules will be submitted to the Secretary of State by July 1, 2013. Thanks to all who have helped to advance the licensing of integrated health in Arizona!

Trauma Informed Care

April 12th, 2012

Trauma Informed Care provides another perspective when working with individuals in the behavioral health system.  Think of it this way, our life experiences have helped shape each of us into the person we are today, why would it be any different for our patients/residents. When a person experiences trauma it can have any number of effects on them.  There is no “one size fits all” approach that works with patients/residents, we have to understand each person individually and craft our treatment approaches to best meet their needs.  I hope you take the time to check out this link as it gives some of the basics about Trauma Informed Care.

Behavioral Health Dashboard Refresh

April 3rd, 2012

Magellan of AZ & their behavioral health providers (and of course our DBHS shop) have been collaborating to develop and update an innovative provider outcomes dashboards to make a transparent window into the effectiveness of the behavioral health system based on core metrics.  The recently updated online dashboards provide great info to the folks that we serve and their families…  but also to the providers themselves.  Each dashboard includes critical indicators that are grouped into balanced scorecard categories. The dashboards can be reached quickly at any time by using the URL @ www.MagellanofAZ.com/dashboards.  The dashboards show trend lines for important performance measures over the last 3 years.  The data speak for themselves- as you can see that there’s been dramatic performance improvement. 

The old mantra from the American Management Association is right: “You get what you inspect, not what you expect.”

Working Together for Health & Wellness

September 21st, 2011

We’ve had to make lots of difficult decisions in response to the ongoing funding shortfalls in our behavioral health system (as well as everywhere in state government).  Many decisions (while painful in the short term) have been necessary to maintain long term system stability as Arizona continues to emerge from this unprecedented fiscal crisis.  While Arizona is gaining ground economically, the progress is slow and requires ongoing, innovative approaches and strong collaboration by all behavioral health system partners.  Because of our partnerships- our system remains strong. 

State government has been working hard to protect coverage and services for individuals with behavioral health needs.  A recent public letter from Dr. Nelson outlined some of our innovations to creatively reinforce our behavioral health system.  We’ve needed to reduce behavioral health provider reimbursement rates, but we’ve taken other actions to help out behavioral health providers and folks that receive services.  For example, we increased the percentage that must be spent on services and decreased the amount of profit behavioral health authorities are allowed to earn- pressing a larger percentage of the total money into services.  

We’re also making real efforts to bring members, families, advocates and stakeholders together as a community to work with a common purpose to preserve and strengthen the behavioral health system.  Members and families routinely sit on our committees and offer valuable input in the redesign of programs that have to operate with less funds. Member-operated organizations such as the Phoenix Visions of Hope have created programs such as warm line crisis response to help members who have lost benefits and need help.  The Family Involvement Center, which offers support to family members in the behavioral health system, has a number of programs to help family members cope with the loss of benefits. 

We’ve also been encouraging the integration of physical and behavioral healthcare among behavioral health providers with acute care health plans and community health centers around the state.  Our new reform initiative will offer whole heath services to persons with Serious Mental Illness in Maricopa County beginning in October 2013.  Tragically, folks with serious mental illness typically die 25 to 30 years younger than the general population, primarily because of physical health issues, many of which are preventable.  This initiative, through the development of Health Homes, will offer these individuals both physical and behavioral health care through one health plan by a team of dedicated health care professionals.  Not only will this new health care delivery system improve health outcomes and reduce costs, there will be an emphasis on prevention, wellness and self-directed disease management programs that have typically not been offered as a routine part of health care.  While these partnerships should also reduce overall healthcare costs, they will also improve quality of care and health outcomes. 

There’s no question that these are tough times and our hearts go out to those who are suffering.  However, we’ll continue to do everything in our power to minimize any harm brought on by budget cuts and continue to make the adjustments in a way that maintains stability and keeps our system strong.  You have my commitment that every decision will be made with our members’ best interest as the number one priority.  Our primary goal—even during these challenging budgetary times—is to provide the best possible behavioral health care to our members and we’re committed to achieving that goal along with our partners in the behavioral health system- and to seek out new ways (like integrating behavioral primary health care) to improve health and wellness.

“Raise Your Voice!” Report

July 15th, 2011

Our behavioral health coalition completed and published our brand-new Raise Your Voice! Report… a product of our behavioral health focus groups with peers and family members in late 2010.  We’re most proud of the fact that the entire process—from beginning to end—had the full participation or peers and family members (from the Arizona Peer and Family Coalition) in planning, organizing, leading and monitoring—making the result a true reflection of their voice.  The Coalition finalized and approved the report yesterday.

 Our behavioral health system transformation team sponsored the series of forums so that folks can express their opinions about how we should shape the future of the behavioral health system in Arizona. The forums actively involved the community through a series of focus groups that gathered the collective opinion of members on what they want and need from the behavioral health system.  The team used 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.

 The first 13 pages of the report provide an easy-to-read summary of the findings. More detail is contained in the attachments to the report including the data and analysis for each question asked in the focus groups. The categories described on the charts are specifically defined for each question using the actual words and phrases spoken and written down in the focus groups.

 We’ll continue to partner with our peer and family run organizations to bring the peer and family voice into the system. This is especially critical as we continue our work to transform Arizona’s publically funded behavioral health care service delivery system.

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.