Posts Tagged ‘physical health’

AZ’s Future Essential Health Benefit Package

October 12th, 2012

The future health insurance exchange plans (as well as most other commercially available plans) will need to offer a standardized (state-specific) Essential Benefit Package once the Affordable Care Act kicks in on 1/1/14.  There are 10 key service categories that future plans will need to cover- including behavioral health services.

States were responsible for picking a plan from a set of existing options to serve as their state’s “benchmark” plan by last week.  Arizona picked the State Employee EPO plan as the benchmark plan that most insurance plans will need to cover (at a minimum) on and off the exchange.  Future exchange health plans (as well as most other commercially available plans) will need to be “substantially equal” to the state employee benchmark plan in the scope, limitations and exclusions (e.g. visit limits).   I think the plan is a good choice because it has a robust behavioral health component with fewer limitations, restrictions and exclusions than most other options- and already covers behavioral health services at parity (meaning behavioral health has the same level of coverage as physical health).

Obviously there’s a lot more to it than that… and folks can get a lot more in-depth info about what an Essential Health Benefit is and what it means in this document- which provides an Arizona specific analysis of the issues and the various services that’ll be covered under the future benchmark plan.

 

Looking Forward, 2012

January 3rd, 2012

Looking forward, 2012 is going to be another busy year for all of us.  During the last Deputy/Assistant Director meeting, managers shared the biggest priorities for the next six months and I will share a few of the highlights throughout this week in our blog.    

One key focus that echoed throughout everyone’s summary was an emphasis on working together across agency programs, with our partners and through our strategic plan.  From the importance of integrating behavioral and physical health to supporting our workforce with cross training, and planning for continuity of operations as staff members retire, ADHS is truly working together. 

The work on merging rules for behavioral health and medical facilities got off to a great start with a series of public meetings.  Six months from now, we expect to have a workable set of draft rules put together.  Operations, behavioral health and licensing are all contributing to this project.  There are also many 5-year Rule reviews getting underway as we speak.

Step Up to the Plate

July 15th, 2011

It’s time to step up to the plate if you’re interested in providing clear and concise information about how best to integrate primary and acute healthcare with behavioral health care for folks with serious mental illnesses in Arizona.  One of our top priorities in behavioral health over the coming years will be to better integrate physical health and mental health/substance abuse services in Arizona.  Why is this a priority you ask?  It’s because folks with the most serious mental illnesses die at least 25-30 years earlier than the average Arizonan.  Physical and mental illnesses are often linked- and when left untreated, folks can experience lost productivity, unsuccessful relationships, significant distress and dysfunction; it can also affect how well they care for their kids.  You can check out several recent blog posts on this topic for more information about where we’ve been and where we’re going.

 One of the ideas that our interagency integration steering committee has been exploring over the last several weeks is shifting to a service model that includes contracting with managed care organization(s) to serve as a Specialty Regional Behavioral Health Authority that would also include a health home for folks with serious mental illness.  The initial idea includes the potential for moving ahead with this new model as we implement the next major behavioral health contract in Maricopa County beginning October 1, 2013.

 The team is inviting interested folks and organizations to provide concise input over the next few weeks by replying to our newly released Request for Information.  In addition, our team has put together a nifty integration website that provides a cornucopia of data and information about integrating primary and acute healthcare with behavioral health care.  On the main page, you can click on the icon for the Specialty RBHA and follow along as work continues on the health home planning grant and the research into a Specialty RBHA.  Additional Stakeholder input will be getting underway in the coming weeks and months as well.

2011 Department Priorities Spotlight- Behavioral Health

December 13th, 2010

Last week, I outlined goals and priorities for the Licensing Division in the coming year.  This week I’ll hit on the Division of Behavioral Health…

One of our primary objectives will be to better integrate behavioral health, physical health, and wellness at the “retail” level (i.e. at the point of care).  By strengthening integration and collaboration with community health centers and other providers of primary care, we expect to improve overall wellness as well as lower the use of emergency departments, decrease admissions and readmissions to hospitals, improve service delivery and improve adherence to treatment plans.  This’ll translate into lower healthcare costs while producing improved health outcomes.  To kick off this year-long effort- we’ll be spearheading a statewide, day-long forum in late January called Integrated Models of Care.  It’s being funded by the Milbank Foundation and will bring together leadership from the behavioral health and community health centers, acute care health plans, AHCCCS, Legislators, and other important stakeholders to address how we can more effectively integrate care & have a positive impact on overall public health and wellness in Arizona.

Another priority will be to roll-out our new ADHS Behavioral Health Outcomes Dashboard.  It’s kind of like a consumer reports report that doubles as a performance touchstone.  The Dashboard will track important performance measures statewide and by Regional Behavioral Health Authorities in the areas of access to care, coordination of care, service delivery, and quality of life outcomes. The Dashboard will provide helpful information to our stakeholders on our performance while demonstrating our ongoing commitment to transparency.  As I’ve mentioned before, we need to be more focused on actual outcomes rather than processes.  We need to turn timely, accurate, and meaningful data to information we can use and act on. This priority will help us in our constant quest to do better but also to recognize progress and achievements along the way.

A third priority is our relationship with stakeholders, including individuals and family members receiving services in our system, advocates, and providers.  The importance of a unified community with common goals, mutual trust and respect cannot be underestimated. Especially during these challenging economic times, strong relationships can facilitate compromise, creativity, and system stability and resilience. Strong leadership is needed, and we’re  committed to meeting that need.

We’ll also continue to focus on overall efficiency, reducing paperwork and maximizing the use of electronic data systems.  We’ll be eliminating our mandated clinical assessment tool that has been in place for many years; instead we’ll focus on making sure that adequate credentialing and clinical supervision occurs for providers who conduct assessments and that clinical outcomes demonstrate individuals are getting better.  The need for service providers have more “face-to-face time” with individuals (instead of filling out paperwork) is something we clearly need to address better.  This will be a big year for behavioral health.