Posts Tagged ‘substance abuse’

Integrated Care Responses On Deck

January 8th, 2013

We all need to take care of both our physical and behavioral health needs in order to be healthy. The mind and body aren’t separated- and neither should the health-care delivery system- especially for folks with a serious mental illness. Folks with a serious mental illness die more than 25 years earlier than the general population… an unacceptable health disparity in anybody’s book. The increased mortality is largely from treatable medical conditions caused by modifiable risk factors like smoking, obesity, substance abuse, and not accessing primary and acute medical care. Population health issues. 

We recognized the need to address this unacceptable health disparity when we put together our Strategic Map and Plan that includes integrating behavioral and acute healthcare. It’s been a long haul and a lot of work- and we passed a major milestone today when folks submitted their bids on our Request For Proposal (otherwise known as RFP) for the delivery of behavioral health services in Maricopa County.  We received bids from: 1) Magellan Complete Care of Arizona, Inc.; 2) Cenpatico of Arizona LLC; 3) Arizona Physicians IPA, Inc. (APIPA), d/b/a UnitedHealthcare Community Plan, operating as UnitedHealthcare Whole Health; 4) Mercy Maricopa Integrated Care; and 5) Partners in Integrated Health, LLC. 

Our evaluation team will begin their analysis shortly…  and we expect the evaluation process to take 8 weeks or so.  The entity that ends up getting the contract will be responsible for delivering both preventative, acute and primary care along with Recovery-based behavioral health services for folks in the public behavioral health system in Maricopa County beginning on 10/1/13.  

It’s difficult to put into words how much work has gone into this solicitation. I know that many of you put this work on top of all your normal work, had put off other projects, and sacrificed some of your home-life for this product- and I just really want you to know that I appreciate it. It’s going to save lives. Stay tuned.

New Electronic Birth Certificate ‘Round the Corner

December 26th, 2012

Our Vital Records shop does a lot more than manage the State’s birth and death certificate system (which we’ve been doing since 1885).  We’re also an integral part of the Nation’s Vital Statistics System, which serves as the backbone of national data sharing in public health. The data collected under the National Vital Statistics System works in partnership with the National Center for Health Statistics to produce critical information on public health topics like teenage births and birth rates, prenatal care and birth weight, risk factors for adverse pregnancy outcomes, infant mortality rates, leading causes of death, and life expectancy.  All these data are retrieved from the nation’s network of Vital Records shops like ours. 

There have been two birth certificate standards that the states are currently following – the 1989 and the 2003 standard. We’ve been one of the states that had been following the 1989 standard- but not anymore.  Beginning the first week in January, we’ll be turning the key on the new 2003 Standard.  The new Electronic Birth Registration System that we’ll be using will collect a lot more public health surveillance data.  It’s also an electronic system- which will make things much faster and efficient.  The new system will have impacts all throughout our Strategic Plan.  Here are a couple examples: 

  • A1 – Reduce Obesity – The former 1989 standard had zero data on the mother’s height and weight- meaning we couldn’t calculate the mom’s BMI.  Starting next week, we’ll be able to collect this data- which will give us better surveillance- and in turn, help us identify more targeted public health interventions- helping us to make progress in reducing critical risk factors for poor maternal and child health outcomes.
  • A2 – Reduce Tobacco Use and Substance Abuse –  The old system only captured generic measures about maternal smoking during pregnancy.  The new system will have specific cigarette smoking data before and during pregnancy- providing rich data for prevention activities- helping us to improve birth outcomes. 

Other important data elements include information on breastfeeding, whether mother received food during pregnancy from the WIC program (helping us to better evaluate our WIC program), critical medical data elements like congenital anomalies, and fertility treatments (Assisted Reproductive Technology)…  all of which provide newer opportunities for prevention.  The public health applications that the new system will provide are too long to list in a short blog like this… but they’re substantial- believe me.  We’re even going to be able to incorporate the data we’ll be collecting in the new system into our new Midwife rules. 

From a customer service perspective, the new system has improved security for fraud prevention and will provide speedier transactions for printing birth certificates at the county level.  Thanks to all the IT and vital records team that put in the endless hours to make this new application possible.

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.

Integrating Physical & Behavioral Health Services to Save Lives

October 11th, 2012

We all need to take care of both our physical and behavioral health needs in order to be healthy. The mind and body aren’t separated- and neither should the health-care delivery system- especially for folks with a serious mental illness. Folks with a serious mental illness die more than 25 years earlier than the general population… an unacceptable health disparity in anybody’s book. The increased mortality is largely from treatable medical conditions caused by modifiable risk factors like smoking, obesity, substance abuse, and not accessing primary and acute medical care. 

We recognized the need to address this unacceptable health disparity when we put together our Strategic Map and Plan. It’s been a long haul and a lot of work- and we passed a major milestone this week when we released our Request For Proposal (otherwise known as RFP) for the delivery of behavioral health services in Maricopa County. The entity that ends up getting the contract will be responsible for delivering both preventative, acute and primary care along with Recovery-based behavioral health services for folks in the public behavioral health system in Maricopa County. The new contract is scheduled to start on 10/1/13. 

It’s difficult to put into words how much work has gone into this solicitation. I know that many of you put this work on top of all your normal work, had put off other projects, and sacrificed some of your home-life for this product- and I just really want you to know that I appreciate it. It’s going to save lives. You can check out the full solicitation on the State’s Procurement website hub- called ProcureAZ.

Energize Our Borders

October 9th, 2012

I just got back from this year’s (30th annual) United States-Mexico Border Governor’s Conference in Albuquerque- called “Energize Our Borders”.  It was an opportunity to further strengthen the ties of friendship, security, and economic prosperity among the 10 states that comprise our United States-Mexico border region.  The Conference is made up of 7 worktables including Agriculture and Livestock; Competitiveness; Sustainable Development; Education; Logistics and International Crossings; Health and Emergency Management; and Border Security. 

As part of my job, I’m your delegate to the Health and Emergency Management Worktable. I worked with my counterpart and good friend, Dr. Bernardo Campillo, the Secretario de SaludPublica, for Sonora (along with delegates from the other 8 states) this week on action items for our 3 joint recommendations: 

  • Strengthen our relationship with the United States-Mexico Border Health Commission in order to better target the prevention of obesity among children and adolescents and to leverage their knowledge and experience in identifying best practices and promote them in the region.
  • Explore methods for program outreach and development related to reducing substance abuse through prevention and treatment programs and improving knowledge on healthy living; reducing vehicular childhood injuries; and highlighting opportunities to promote Medical Tourism.
  • Work with our federal authorities to establish a framework to support cross-border emergency mutual aid, and provide for the cooperation of states, counties and cities during emergencies and natural disasters.

We’ll execute the joint recommendations over the next year using specific action items.  For example: Arizona and Sonora have been focusing on reducing vehicular childhood injuries by exploring how we could use the Safe Kids model bi-nationally, since Safe Kids Mexico now exists and is actively looking at how to develop their state programs. Thursday I gave a presentation about how we use Safe Kids here in Arizona and perhaps how the work that Arizona and Sonora is doing could be used as a model for the other states along the border.

Accolades

July 16th, 2012

Our own Dr. Laura Nelson was recognized for her outstanding leadership and skills as President of National Association of State Mental Health Program Directors. Her service was rewarded at the annual conference for State Alcohol and Drug Abuse Directors where she received the presidents award for her work!  While presenting the award, the president called Dr. Nelson, “an impeccable advocate for substance abuse and mental health services”.  Mark Singer continued praising her with words like impeccably professional, polite, ethical, caring and considerate.  We all know that about her – but it sure is nice to hear that type of praise on a national stage.  It reminds us that we are lucky to have someone with her skills advocating for those with mental illness in Arizona.  

Congratulations amiga.

New Border Health Resources

May 7th, 2012

Obesity, injury prevention, teen pregnancy, and substance abuse are all border health priorities.  Our prevention team put together an inventory identifying current programs addressing these priority areas in AZs border communities.  Our WIC program and Arizona Nutrition Network reach thousands of low-income women and kids along the border- improving nutrition and reducing obesity.  Programs like our Sexual Violence Prevention & Education and Safe Kids coalitions work to address injuries. 

Our women’s and children’s health shop just finished an analysis of  Teen Pregnancy in Border and Non-Border Counties in Arizona.  Teen pregnancy rates along the border have declined significantly in the past decade.   The border counties have higher rates of teen pregnancy among 15-17 year olds, but lower rates among 18-19 year olds compared to non-border counties. 

Also this week…  the national office of the March of Dimes issued a three-year analysis of various maternal and child health indicators in its March of Dimes MCH Border Report.  The report finds that Arizona residents of border communities have lower rates of prenatal care and higher rates of infant mortality than the non-border counties, but have lower preterm birth.

AZ’s Behavioral Health State Plan

April 9th, 2012

Our Division of Behavioral Health Services recently submitted its combined mental health and substance abuse prevention and treatment services State Plan for FY 12-13 to the Substance Abuse and Mental Health Services Administration. The Plan that we submitted doubles as the State Plan that’s required by ARS 36-550.01. The Plan provides an overview of Arizona’s behavioral health prevention, early identification, treatment, and recovery support systems including how the public behavioral health system is currently organized at the State, County and local levels. It describes the child and adult service delivery systems highlighting their similarities and differences and how these systems address the needs of diverse racial, ethnic and sexual gender minorities as well as youth who are often under-served.

National Poison Prevention Week

March 23rd, 2012

This week marks the 50th anniversary of National Poison Prevention Week. For the first time ever- poisoning surpassed car crashes as the number one cause of injury deaths in AZ and more than 2,000 kids had to go to emergency rooms last year from unintentional poisoning.  Kids under 5 had the highest rates of non-fatal emergency department visits from poisoning.  For more information on poisoning in Arizona, check out our recently posted Poisonings Among Arizona Residents, 2010 PowerPoint

Nationally, more than 60,000 young children end up in emergency rooms because they got into medicines while their parent or caregiver was not looking.   The new  Up and Away and Out of Sight  educational program was created to remind families of the importance of safe medicine storage. 

Phoenix Magazine also wrote a story that explains prescription drug abuse from the perspective of someone battling chronic pain.. it’s called Bad Medicine and is in the Top Docs issue… so hopefully a lot of people will read it, take stock of their “inventory” and dump it before there are more accident poisonings.

 

Arizona Mexico Commission Progress

February 10th, 2012

I’m writing this from my hotel room in Rocky Point- after a long day (and night) of the inter Plenary Session.  The 2 day conference started Thursday and goes through tonight.  We meet twice a year- it’s basically an opportunity for us to form partnerships across the border and to develop regional approaches to things like valley fever surveillance, burn patient infrastructure, substance abuse, TB, border first aid, farmworker health, and Sonora’s efforts to provide licensing and quality assurance services for assisted living in Sonora (and how we can partner with them as they set up their program). 

During last summer’s Session we signed a bi-national Declaration to develop regional surveillance for valley fever.  We’ve made a lot of progress in the last 6 months, and tomorrow we’ll be following up on that initiative at Sonora’s public health laboratory, checking out the lab instruments and equipment that we were able buy (with federal funds) and indefinitely post in Hermosillo in their lab. We’ll also be setting up some joint training sessions. There are lots of other examples of what we do through the Commission on health- this is just an example. 

The Arizona Mexico Commission was started by then Arizona Governor Paul Fannin in 1959 to improve partnering between Arizona and Sonora in a wide range of areas.  It’s evolved over the years to become a premiere and unique cross-border nonprofit organization whose mission is to improve the well-being and quality of life for residents of Arizona by promoting a strong, cooperative relationship with Mexico and Latin America through advocacy, trade, networking and information.  The Commission has 14 bi-national committees that act as industry and community advocates in partnership with the Commission Sonora-Arizona (from Sonora, Mexico) to facilitate cross-border trade, business and community networking and bi-national information sharing.  Our link is through the Health Services Committee.

Click here to see some of the public health facilities and an ambulance they use on the beach.