Archive for the ‘Behavioral Health’ category

ADHS SWAT Team Strikes

April 17th, 2014

ASH recheckLast week the ASH Pharmacy began having problems with the computer system that the medical staff use to order prescriptions for patients.  Orders weren’t consistently showing up on the pharmacy computer screen or printing out.  We implemented our back-up system right away, but the temporary work-around was time consuming.  Our Information Technology team made this their highest priority to figure out what was wrong and fix it.

Our I.T. team and our vendor (Netsmart) found a creative solution and the the system is up and running again.  A million thanks go out to Raghu Ramaswamy, Chris Long, Robert Cooprider, Nita Surathu, Desi Grosso, Daryl Hall, Eric Hill, Chris Peak, Dave Gilbert, Janet Slawinski, Paula Mattingly for the creative technology solution and the Hospital leadership team; our pharmacy team (especially Brianna Englett) for their diligence in working out the emergency back-up process to ensure patient safety; and our nursing and medical staff for ensuring that patient safety was priority #1.


5 Years of Behavioral Health Innovation Paying Dividends (Part I)

April 15th, 2014

MPeople with a serious mental illness die more than 30 years earlier than people without those challenges.  Over the next few weeks, I’ll be reflecting about some of the innovative strategies that we’ve implemented with our behavioral health community partners over the last several years to improve the health status of folks with a serious mental illness.

I’ll start with a project that began with modest funding from SAMHSA, through a grant meant for small pilots to test concepts in our community.  In 2009, we and AHCCCS jointly applied for and got a Transformation Transfer Initiative grant which was used to initiate a peer-based whole health program Maricopa and Pima Counties.  The goal of the program was to help transform the behavioral health system into one that applies a holistic approach to consumer health.

Magellan Health Services of Arizona launched the first phase of Integrated Health Homes as part of this initiative- bringing together mental health and physical health care.  The model was a partnership between Magellan, Maricopa Integrated Health System, and CHOICES Network, Partners in Recovery, People of Color Network and Southwest Network.  By 2013, there were 10 Integrated Health Homes in Maricopa County that have been providing coordinated care for members.  Thousands of people have received coordinated care and achieved better outcomes through these health homes.  Here are some additional typical health home participant vignettes that profile service recipients who can benefit from the initiative.

In the coming weeks, I’ll cover improvements in the Crisis Response System, the kids system of care, children’s substance abuse, coordination with the correctional system, and performance dashboards.

And Now, the Rest of the State

April 7th, 2014

Now that the transition to a new Behavioral Health Authority in Maricopa County is underway- we’re turning our attention to bringing integrated care to the rest of the state.  We’ll be working hard throughout 2014 to set the course for integrating behavioral health and physical health for folks with a serious mental illness as we select behavioral health authorities in the rest of Arizona – it’s called the “Greater Arizona RFP.

We’ve decided that the Greater Arizona RFP will include integration of behavioral and physical health for folks with a serious mental illness- much like the Maricopa County contract.  People in the general mental health or substance abuse categories will get behavioral health services from the RBHA and their physical health care from an AHCCCS acute care health plan.

We’re also planning to consolidate several of the current Geographic Service Areas (GSAs).  We’re likely to have a total of 3 service zones (North, South, & Maricopa)- rather than the current 6.  We’re also going to ensure that tribal land aligns with the GSAs.  Of course- tribes wishing to continue as a Tribal Behavioral Health Authority would continue as-is. Finally, we’re inclined to include a provision in the solicitation that makes it clear awardees will only be able to hold a contract in 1 GSA.  We’ve also made some decisions regarding how we’ll be dealing with Medicare issues.

We plan on issuing the Request for Proposal (RFP) in July, review the proposals from October through December, and award the contracts just before the New Year- with an October 1, 2015 start date.  Stay tuned.  There’s still more work to be done- and some decisions to be made before we put the procurement on the street this Summer.

Opening Day: Mercy Maricopa Integrated Care

April 4th, 2014

openingdayThis was a milestone week for our behavioral health program.  Tuesday marked the start of our contract with Mercy Maricopa Integrated Care as the regional behavioral health authority in Maricopa County.  The transition has gone well this week.  Literally 100s of things had to go right in order to have a smooth transition- including Information Technology, eligibility, pharmacy, medical records, claims management, network capacity and a host of other things.  A big thanks go out to the folks at Magellan, MMIC, AHCCCS and our DBHS, IT, and procurement teams for the weeks and weeks of hard work that it took to have a smooth transition for our members.  Well done!

Mercy Maricopa’s core mission is dedicated to providing its members access to care for their behavioral and medical health needs — focusing on the whole person, taking a holistic approach and empowering members to take charge of their health care. A new, secure health information exchange will help physical and behavioral health care providers to share information- leading to better care coordination, improved health outcomes, and reduced costs. Folks interested in learning more about Mercy Maricopa Integrated Care can visit their website, which has a host of resources for members and health care providers.

We’re optimistic that our collective hard work over the last couple of years to develop this new system of care will continue to result in better public health outcomes consistent with our Vision of Health and Wellness for all Arizonans.

Case Dismissed: Jason K v. Humble

March 28th, 2014

Most of you know that we’ve reached a final agreement with the Plaintiffs in the 32 year-old Arnold vs. Sarn lawsuit.  We expect to have a dismissal hearing later this year- which will officially end the Arnold lawsuit.  We got some other good news on a different behavioral health case last week.

Last Friday marked the end to the 22+ year JK v. Humble lawsuit.  It was a class action lawsuit filed in 1991 by children eligible for or in need of behavioral health services under Medicaid.  We were Defendants in the case along with AHCCCS.  Last week the Plaintiffs asked that the case be dismissed… and the court followed suit by officially dismissing the case right away.  You can learn more about the children’s system of behavioral health services on our website.

Arizona State Hospital In Good Standing

March 14th, 2014

Last September the Arizona State Hospital (ASH) was inspected (surveyed) for the Centers for Medicare and Medicaid Services (CMS). The survey team can review over 20 different areas and three were identified that we needed to address: Governing Body, Patient Rights, and Nursing Services.   In December, we developed and implemented a Plan of Correction which was submitted to CMS.  Some people think certification or licensure surveys are something to fear.  At the Arizona Department of Health Services (ADHS) and particularly at ASH we take a different approach.  Surveys are an opportunity.  They are part of the quality improvement process that health care facilities employ to make sure patients receive high quality care.  

A few weeks ago we had a return visit from CMS surveyors to verify whether we executed our Plan of Correction.   The entire team at ASH did a great job during the inspection- ensuring that the surveyors had everything that they needed to meet their objectives.  The required documentation was easy to find, and the surveyors got to see how well our team works together.  Today we received good news from CMS.  They’ve concluded that we’re satisfying their requirements, and that the Arizona State Hospital is in good standing, including our Deemed Status as a result of our Joint Commission Certification.  Congratulations Team ASH. 

Having external entities such as CMS and the Joint Commission (JC) review your organization creates an exceptional opportunity to get a fresh set of eyes on what a facility is providing for services.  If you think about it in the quality realm, the survey is an evaluation using evidence based practices.  Survey and accreditation standards are built to determine whether programs are delivering services in accordance with the accepted “Standards of Care” that have been developed from years of surveys, experience, research and best practice from regulators, clinicians, academics, legal analysis and patient experience.  Why would a program not want to have an opportunity to be evaluated according to these standards? 

So while some people look at surveys and their results as a negative reflection on the program we need to reframe that look from the lens of quality.  We want quality services and outcomes for patients.  Learning from both internal and external quality processes helps organizations meet those goals.  Continuous quality improvement only happens when you continually evaluate the services through the quality lens.  The team at ASH and ADHS is proud of the work that staff at every level are doing to meet the needs of some of Arizona’s most vulnerable citizens and fulfill our requirement of delivering high quality care. 

BTW: You can read more about some of our initiatives to improve the quality of care at the State Hospital here and here.

Today’s Arnold v. Sarn “Fairness Hearing” a Success

February 27th, 2014

A few weeks ago the Governor announced a final agreement had been reached in the 32 year old Arnold vs. Sarn case regarding care and services for individuals with serious mental illness. The Settlement is the foundation to end the lawsuit while establishing a blueprint for a successful community-based behavioral health system in Arizona. 

This morning we had a fairness hearing in Maricopa County Superior Court on the case. The Governor and I were among the speakers.  The hearing went well, and at the end, Judge Bassett entered an Order from the bench that accepts the Settlement Agreement. Under the terms of the stipulation approved by the Court today as fair and reasonable, Arizonans with serious mental illnesses will be assured of enhanced community-based services that allow them to participate in society in a meaningful way, including: crisis services; supported employment and housing services; assertive community treatment; family and peer support; life skills training; and respite care services. Additionally, the stipulation includes metrics, national standards and evidence-based best practices to ensure quality, transparency and accountability in Arizona’s mental health system. 

We expect to have a dismissal hearing later this year- which will officially end the Arnold vs. Sarn lawsuit that was filed in 1981. Of course, we’ll still be expected to live up to the terms of the Settlement- which is among our Agency’s top priorities.

Maricopa County Transition Moves a Step Closer

February 26th, 2014


Last week a Superior Court Judge denied a motion to Stay the transition of the Maricopa County behavioral health services contract from Magellan to Mercy Maricopa on April 1.  With this ruling it looks like everything is happening according to schedule. Magellan still has the opportunity to appeal the decision and exercise due process in the matter… but we’ll continue pressing ahead with the transition.

Stay in touch with what’s happening in the behavioral health world by reading our ADHS Behavioral Health Services Blog.

ASH Recheck

February 13th, 2014

Last week we had a visit from CMS (Medicare) to check on our plan of correction from a Survey that was conducted last fall at the Civil Units.  Although we won’t get a final report for a while…  we do know that Team ASH did a great job during the survey- ensuring that the surveyors had everything that they needed to meet their objectives.  The required documentation was easy to find, and the surveyors got to see how well our team works together.  

Good teamwork and professionalism all the way around.  Keep up the good work!


Behavioral Health Transition Going Smooth

January 31st, 2014

As Cory mentioned in his blog awhile back, our award of the Maricopa County integrated behavioral health services contract to Mercy Maricopa Integrated Care (Mercy Maricopa) was affirmed and the Stay on transition activities was lifted a few weeks ago.  Magellan elected to exercise their right to additional due process and has filed a Motion in Superior Court asking for additional review of our and ADOA’s decision. 

In the mean-time, our team has been working hard with Magellan on the day-to-day management of the current contract as well as continuing to work with both Magellan and Mercy Maricopa on more than 100 transition activities… which are going well.  Magellan has submitted more than 61 out of 99 transition deliverables, and none have been late.  Mercy Maricopa has turned in 74% of their deliverables- and is on track to be ready before April 1. 

We’ve also been continuing our community engagement to let members know about the transition.  Here’s an educational video English [Spanish] and slides that we’ve been sharing with members.  In short, we continue to be on-track for a smooth transition on April 1.