Posts Tagged ‘Regional Behavioral Health Authority’

Maricopa County Behavioral Health Contract Update

June 19th, 2013

Last week the AZ Department of Administration decided to ask the Arizona Office of Administrative Hearings to conduct an official hearing regarding our October 1 contract award for the Regional Behavioral Health Authority in Maricopa County.  You may remember that the ADOA issued a stay last month that stopped the transition process.  We received a notice from the ADOA yesterday that the hearing is scheduled for the week of August 12.

In the meantime, our procurement and legal team will be preparing for the August Hearing…  and our folks on the 2nd floor will be busy working on the integration processes.  No matter what happens with the contract, we’re working hard to ensure that we will soon have medical care integrated with behavioral health care for the people in Maricopa County.

Suicide Prevention: A Winnable Battle

December 18th, 2012

Back in 2009, AZ had the 9th highest rate of suicide in the U.S.  In that year 1,060 Arizonans took their own lives- so it’s easy to see why suicide prevention is an agency priority and is featured in our Strategic Map as a Winnable Battle.  Since we’re responsible for the state’s behavioral health system- we have a leverage point…  especially for the folks that receive services through our public behavioral health system including crisis services. 

One of our primary interventions for this Winnable Battle has been our collaborative Suicide Deterrent System, which was launched in 2009 by Magellan (our Regional Behavioral Health Authority in Maricopa County).  It’s evolved into a training initiative for behavioral health professionals to a comprehensive national model addressing one of the most at-risk populations – folks diagnosed with mental illness. Since kickoff, the initiative has trained more than 3,000 behavioral health care staff to recognize the signs and symptoms of suicide in persons with mental illness, and to help them stay safe and seek help.  The program has also addressed family engagement and support groups for suicide attempt survivors- and has developed clinical tools and procedures for assessing risk and appropriately intervening. 

The ADHS and Magellan Health Services of Arizona won a Council of State Governments Innovation Award this year for the Suicide Deterrent System.  The objective of the Suicide Deterrent System is to make suicide a “never event” for those served by our public behavioral health system.  Nationally, most public sector behavioral health care systems have made suicide prevention a business side-line…  relying mostly on crisis interventionist specialists.  Our model recognizes that to be successful, we need to provide safe, effective, patient-centered, timely, efficient, and equitable care. Our systems approach brings the core business of state-funded behavioral health care to tackle the challenge, including a systematic “do whatever it takes” approach, top leadership commitment, measurement and reporting and robust performance improvement. 

Our collaborative initiative has changed the mindset about suicide prevention. By providing knowledge, skills, tools and management support, this project has made suicide intervention a core responsibility of all behavioral health staff. It recognizes the complexities of suicide and addresses: 1) Behavioral health workers’ skills/confidence to intervene (Applied Suicide Intervention Skills Training – ASIST); 2) Connectedness for those contemplating suicide (attempt survivor support groups, family engagement); and 3) Risk identification and stratification (clinical care and intervention).

Outcomes: Public Health’s Lighthouse

October 16th, 2012

One of our primary objectives over the last couple of years has been to shift the focus of our performance measures away from process and procedures toward actual outcomes.  In other words, we don’t want to measure our success on whether someone’s paperwork is right, but on whether the services we provide actually help folks achieve their recovery goals.  That’s why it’s so exciting to see the system continue to develop easy-to-use behavioral health outcomes dashboards as a new performance tool and to inform consumer choice. 

Outcome Dashboards are like a scorecard- allowing folks to easily review performance and outcomes information (employment, housing, staying out of crisis centers, abstaining from substance abuse, avoiding arrests, etc.) at the at the tip of a finger by region of the state.  Links are also included so the user can then visit dashboards developed by each Regional Behavioral Health Authority, where provider-level performance can be reviewed. 

Our updated Behavioral Health System Performance Framework and Dashboard provides an easy to read outcomes summary including dials for Quality of Life, Access to Services, Service Delivery, and Coordination/Collaboration metrics.  Each category includes demographic data provided by clients, audits of client records, analysis of claims and survey data reported by the Regional Behavioral Health Authorities.

ADHS is Seeking an Insightful, Creative Leader for Behavioral Health

May 15th, 2012

Do you think you can help us in “Promoting Health and Wellness for all Arizonans”.  That’s the motto here at ADHS and we are looking for a new leader to join our Behavioral Health team.

We’re looking for an Assistant Director who is insightful and can see the forest and trees at the same time.  This person oversees general business operations, contract compliance and work on policy development.  We’re looking for a caring, forward thinker to join our team that cares for all the folks in the public behavioral health system.

Visit the state jobs website and put in health services.  We’ll start reviewing applicants after May 25th.

Behavioral Health Outcome Dashboards Really Taking Off

July 18th, 2011

One of our primary objectives over the last couple of years in behavioral health has been to shift the focus of our performance measures away from process and procedures toward actual outcomes.  In other words, we don’t want to measure our success on whether someone’s paperwork is right, but on whether the services we provide actually help folks achieve their recovery goals.  That’s why it’s so exciting to see the system continue to develop easy-to-use behavioral health outcomes dashboards as a new performance tool and to inform consumer choice.

 Outcome Dashboards are like a scorecard- allowing users to review performance and outcomes information (employment, housing, staying out of crisis centers, abstaining from substance abuse, avoiding arrests, etc.) at the statewide level, as well as by region of the state and separately for adults and children. Links are also included so the user can then visit dashboards developed by each Regional Behavioral Health Authority, where provider-level performance can be reviewed.

 By working closely with our behavioral health contractors we’ve been able to make some significant improvements in the quality of care that we’re providing.  Examples of our accomplishments are available in outcome dashboards developed by CPSA, NARBHACenpatico and Magellan.  The dashboards provide monthly reports using web-based tools, are accessible to anyone and highlight indicators of quality of care for recipients and their families that they can use for consumer choice.

 A couple of weeks ago Magellan Health Services of Arizona launched a new adult general mental health and substance abuse provider outcomes dashboard. This new dashboard provides important performance information throughout the system of care- and is a significant enhancement of the outcome dashboard that they created for adults and kids with serious mental illnesses.  The new dashboard for general mental health and substance abuse contains 14 key indicators under the following four outcomes areas: clinical, coordination, recovery and accountability. The dashboard can be reviewed from various perspectives.  Check out Magellan’s new general mental health and substance abuse dashboard at www.MagellanofAZ.com/Dashboards.

Behavioral Health Integration Progressing

July 12th, 2011

You’ll remember that ADHS and AHCCCS jointly applied for and received a $750K Planning Grant to explore integrating primary health care and behavioral health care- especially for folks with serious mental illnesses.  Our teams have been very busy over the last couple of weeks getting the initiative underway.  One of the concepts we’re exploring is a specialty Regional Behavioral Health Authority (RBHA) containing a Serious Mental Illness (SMI) Health Home. 

 Our Interagency Steering Committee is exploring the feasibility of contracting with managed care organization(s) to serve as a Specialty RBHA with SMI Health Homes in Maricopa County beginning October 1, 2013. The team has been working hard on a Request for Information (RFI) that we expect to release in the very near future to help us with our planning.  Meanwhile, our IT web design folks have been putting together a new website that should be ready to roll out next week.  Additional Stakeholder input will be getting underway in the coming weeks and months as well.  Stay tuned!

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.

Tucson Response

January 11th, 2011

I know many of you are following the tragedy that occurred over the weekend in Tucson. If you’re like me, you’ve been trying to make sense of something that is senseless.  It is not uncommon to have a variety of reactions to a sudden and violent event such as this, and you may be struggling with how to respond to your own feelings or those of your family members, especially your kids. We’ve got a variety of resources that you might find helpful.

And, as an employee, you have access to the Guidance Resources Program 24 hours a day, 7 days a week just by calling 1-877-327-2362. You can also access it online at www.guidanceresources.com. You can schedule a time with an Employee Assistance Program (EAP) approved counselor and receive up to 6 free individual sessions.

For those who don’t have programs like that, there are two hotlines set up to help answer your questions and deal with any issues you may have.  Those who live in Pima County can call 520-284-3517 and those who live in the rest of the state can call 800-203-CARES (2273).

And a special thanks to the Division of Behavioral Health Services and Emergency Preparedness Teams as they are working to support the Pima County RHBA—CPSA and Local Health Office to help coordinate the crisis response.

Behavioral Health Services in SE Arizona

September 27th, 2010

Folks that receive publicly-funded behavioral health services in Cochise, Santa Cruz, Greenlee and Graham Counties will soon transition to a new Regional Behavioral Health Authority (RBHA).  In March, ADHS awarded contracts for all of the areas outside of Maricopa County.  We awarded the contract for Cochise, Santa Cruz, Greenlee and Graham Counties to Cenpatico Behavioral Health of Arizona (Cenpatico) but Community Partnership of Southern Arizona (CPSA) challenged our decision, suspending the transition.  That challenge has now been resolved and beginning December 1, 2010, Cenpatico will operate as the RBHA for these counties.  There are approximately 5,300 adults and children receiving publicly-funded behavioral health services in these counties.

A special thanks go out to our Procurement Team and all of the folks that were involved in the review and evaluation process.  The procurement process is rigorous and demanding, and our team did a very good job crossing the t’s and dotting the i’s to make sure that the whole process was done by the book.

Behavioral Health Medicine Transition Update

September 9th, 2010

As you recall, the ADHS budget reduction last fiscal year required us to scale back the services we provide to folks who were receiving behavioral health services but don’t qualify for AHCCCS (called Non-Title XIX).  We also needed to switch to a “generic formulary” for Non-Title XIX folks on July 1 (which saves about $7M/year).  We had initially intended to implement the generic formulary on July 1, 2010, but as that date approached, it became clear that some individuals needed more time to ensure that patients could be safely transitioned, so we modified our guidance document to allow the transition of remaining members by October 1, 2010.

We also added one name brand medication called Risperidal Consta, a long-acting injectable antipsychotic medication, to the formulary.  There are numerous class equivalent antipsychotic medications still on the formulary to choose from as an alternative to the remaining name brand med’s, including long-acting injectables like Haldol Decanoate and Prolixin Decanoate. (As an aside, our TXIX formulary is among the most robust in the nation).

We’ve also asked our Regional Behavioral Health Authorities (RBHA) & Providers to have their doctors and patients apply for the pharmaceutical Patient Assistance Program if they or their patient believe a brand name med that has no substitute and is not on the formulary.  We developed tips for accessing brand name meds to help streamline the process.  We have been getting feedback that many individuals have been successful getting on Patient Assistance Programs.

If the patient doesn’t qualify for a pharmacy Patient Assistance Program (usually because of income), we’ve asked the RBHAs to make sure the patient knows about the new Pre-existing Condition Insurance Plan, which they may be able to afford.  We also encourage the RBHAs to help patients apply for a medication discount card so they can get medicine at a reduced rate.   Also, doctors may be able to obtain samples from the pharmaceutical company and provide those to patients at their discretion.

We’ve been conservative in our financial modeling and projections to make sure we avoid the need to cap enrollment and wait list new members later in the fiscal year.   We’ll continue to carefully examine our Non-Title XIX expenses as the first quarter progresses.  We’d like to expand the formulary to include additional name brand meds if we can later in the fiscal year, but our top priority is to make sure we avoid an enrollment cap toward the end of the fiscal year.