Archive for the ‘Behavioral Health’ category

Child and Family Teams Improve Outcomes

November 5th, 2014

child-family2The use of a Child and Family Team is a service offered to all children, adolescents and young adults under the age of 21 enrolled in the Tribal and Regional Behavioral Health Authority systems.  The teams are comprised of people important to the child and their development and focus on family group decision making to meet the child’s individual needs. These teams know the child’s strengths and abilities, and can identify needs the child may have that can be addressed through wraparound or individualized services.

Our Public Health Statistics group teamed up with the Division of Behavioral Health Services to see if Child and Family Teams  improve the success of the kids in our Behavioral Health system.  We looked at two outcomes: avoiding delinquency and success in school.  By evaluating things like: compliance with probation, decreased substance abuse, improved grades, completing homework and participating in extra-curricular activities, we were able to show that kids participating in a Child and Family Team had better outcomes than those who did not participate.

This study was recently published in the Journal of Child & Adolescent Behavior and adds valuable information to the limited evidence available. Congratulations to Khaleel Hussaini and his team!

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Bids In for Integrated Behavioral Health Contracts

October 13th, 2014

Rendered Arizona FlagNow that we have a new integrated behavioral health care model in Maricopa County, we’ve set our sights on implementing a similar integrated care model in the rest of the state.  Our Procurement Team closed the bidding for the Greater Arizona Behavioral Health RFP last Thursday afternoon.

This important procurement solicited bids for providing integrated 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.

The solicitation consolidated several of the current Geographic Service Areas.  When the new contracts go live in October of 2015, we’ll have a total of 3 service zones (North, South, & Maricopa) – rather than the current 6.  We’ve also ensured that tribal land aligns with the service areas.  Of course, tribes wishing to continue as a Tribal Behavioral Health Authority would continue as-is.  The solicitation makes it clear that awardees will only be able to hold a contract in 1 service area.

We received 3 bids for the Northern service zone (Magellan Health Services; Health Choice Integrated Care, LLC; and UnitedHealthcare Integrated Services, Inc).  The Southern service area also had 3 bidders (Magellan Health Services; Cenpatico of Arizona LLC; and UnitedHealthcare Integrated Services, Inc.).  We’ll be evaluating the bids over the coming weeks and awarding the contracts by the end of this year… with an October 1, 2015 start date.

Case Dismissed: Arnold v. Sarn

September 28th, 2014

gavel-214x300After more than 30 years of litigation, the Maricopa County Superior Court last week dismissed the Arnold v. Sarn lawsuit, retaining jurisdiction to enforce the on-going agreement that lead to this historic resolution. The dismissal is the result of a comprehensive joint stipulation – filed by the parties and approved by the court earlier this year – that ensures a successful and quality community-based behavioral health system.

The final agreement approved by the court specifically concerns care and services for people with a serious mental illness. That Settlement became the foundation to end the lawsuit and established a blueprint for a successful community-based behavioral health system in Arizona.

Last week the Judge accepted the terms agreed to by all the parties and dismissed the case- officially ending the 1981 Arnold v. Sarn lawsuit.  We’re still required to live up to the terms of the Settlement including increasing Assertive Community Treatment, Supported Employment, Supportive Housing and Peer and Family Services.  We’ll be using evidence-based tools to  evaluate the system’s performance, including ongoing Quality Service Reviews, Network Capacity Analyses and adherence with SAMHSA Fidelity Tools. Our Arnold v. Sarn website will continue to provide transparency on our performance under the Settlement Agreement.

This is an historic achievement, not because the case has been dismissed, but because we’ve been able to build a successful community-based behavioral health system that’s held accountable using evidence-based criteria, providing people living with a serious mental illness with the resources and help on their path to Recovery.

Employment First Initiative

August 12th, 2014

PArizona Developmental Disabilities Planning Council is sponsoring a series of six Employment First Community Forums to develop a comprehensive strategic plan designed to promote employment for individuals with developmental and intellectual disabilities.  A broad coalition of self-advocates, family members, service providers, educators, state agencies, advocates and employers are sharing ideas and strategies to raise public awareness, promote an attitudinal shift, build capacity, aimed at bringing about systems change.  It’s all about integrated and competitive employment, or real jobs earning minimum wage, for all working age Arizona residents with disabilities.

There’s still time to join the discussion.  Participate in one of the final Community Forums in Tucson (August 12) or Yuma (August 14).  Become involved in a movement that’s helping Arizona improve its economy by supporting businesses to find talent and meet their needs by hiring individuals with disabilities.

To learn more about Arizona’s Employment First Initiative, or to register for a Community Forum, please contact Michael Leyva, Arizona Developmental Disabilities Planning Council mleyva@azdes.gov.

The 5th “Vital Sign” & the Painkiller Epidemic (Part II of V)

August 6th, 2014

painkillersLast week (in Part I of this 5-part series) I introduced the idea that contemporary pain management strategies have resulted in an epidemic of painkiller misuse and abuse that’s killing large numbers of people.  In fact, misuse and abuse of opiate prescription painkillers takes out more people every year than car crashes.  The run-up to the current epidemic appears to have its roots in including pain as the “5th Vital Sign” in national pain management strategies.

In the 16 years since pain as the 5th Vital Sign was introduced, the misuse and abuse of prescription drugs has become the leading cause of injury death in the US.  According to CDC, SAMHSA, and leading national experts, every day in the United States, 113 people die as a result of drug overdose, and another 6,748 are treated in emergency departments (ED) for the misuse or abuse of drugs.  In 2004 there were approximately 600,000 ED visits tied to prescription drugs in the US.  By 2010 that number had reached 1.4 million – more than doubling in just 6 years.  From 1999 to 2010, the CDC’s Wonder online database reported opioids as the leading cause of drug overdose deaths.

According to the National Institute on Drug Abuse, the number of opioid prescriptions dispensed in the US went up 300% from 1991 to 2011.  Findings published in Addressing Prescription Drug Abuse in the U.S.:  Current Activities and Future Opportunities suggest that not only has the number of opioid prescriptions increased, but so has the amount prescribed per prescription, the daily supply, and the cumulative dose.

Arizona prescribers wrote 82 prescriptions per 100 people in 2012 and Arizona has the 12th highest prescription rate of extended release and “high dose” opioid pain relievers in the US.  According to SAMSHA’s National Survey on Drug Use & Health Arizona has the 6th highest rate of past-year nonmedical prescription opioid pain reliever use in the US.  Finally, the Arizona Prescription Drug Misuse & Abuse Initiative reported that last year enough prescription painkillers were prescribed in Arizona to medicate every adult around the clock for more than two weeks.  Just think about that.

Next week (in Part III) I’ll present research investigating relationships between pain as the 5th Vital Sign, pain assessment and pain management outcomes as well as recommendations by experts for future research.

Behavioral Health “Summer Institute”

July 28th, 2014

conferenceSeveral staff from the Division attended and conducted presentations at the annual summer institute held by ASU’s Center for Applied Behavioral Health Policy.  This is the largest local conference for behavioral health professionals.  This conference was originally created by our Behavioral Health Division in collaboration with ASU 15 years ago.

Today, it continues to provide professional development and continuing education opportunities in addition to networking and updates of the latest industry trends.  This year’s theme was “Resiliency and Whole Health,” and it offered various workshops on recovery, integrated care, and related evidence-based practices.  Sessions included “Lessons Learned from Behavioral Health RFPs” presented by Cory Nelson, along with Victoria Navarra, who leads the program that coordinates the work for the RFPs, and Claudia Sloan, who led the communications strategies for the RFPs.

Another interesting session was: “SBIRT – A Step into Integrated Care” and was presented by NARBHA but received support developing and preparing for the presentation from Alexandra O’Hannon, our contact lead for the SBIRT initiative.  “Healthy Living: Implementation of Stanford’s CDSMP in Behavioral Health” was presented by Claudia Sloan along with partners from the Arizona Living Well Institute and NARBHA.

Kelli Donley, who has been project-managing our exit from the historical Arnold vs. Sarn suit presented “Arnold v. Sarn and the Implementation of SAMHSA Fidelity Tools in Maricopa County”.  Our staff also collaborated with ASU during the planning for this year’s town-hall which focused on the needs of vulnerable adolescents and young adults.  Thanks to all of you that helped make this year’s Summer Institute a success again.

New Website for Arnold v. Sarn Case

July 16th, 2014

gavel-214x300A few months 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.

The Agreement includes an increase of services in four areas: Assertive Community Treatment, Supported Employment, Supportive Housing and Peer and Family Services.  The Agreement also provides for the use of several tools to evaluate services provided in Maricopa County, including a quality service review, network capacity analysis and SAMHSA Fidelity Tools.

This week we launched a new Arnold v. Sarn website that provides transparency on the review process.  The site will feature details about each of the four SAMHSA Fidelity Tools being implemented along with reports on how we’re doing at each.  By early August we plan to have online self-paced video presentations about the evidence-based tools.

Additionally, we hit the ground running with the fidelity reviews process – we added four new team members to our behavioral health team and have trained them over the past couple of weeks to serve in the role of fidelity reviewers.  You can read about them and their role on the site.  Technical assistance sessions for the community are planned and will take place over the next couple of months.  A big thanks to Kelli Donley and our entire behavioral health team for coordinating this evidence-based initiative.

 

Behavioral Health Services for 14 Counties Go Out to Bid

July 15th, 2014

gsa-mapNow that we have a new integrated behavioral health care model in Maricopa County, we’ve set our sights on implementing a similar integrated care model in the rest of the state.  Our Procurement Team issued the Greater Arizona Behavioral Health RFP last week – which sets 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.

The Greater Arizona Behavioral Health RFP solicits bids from entities that provide integrated 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.

The bid is structured to consolidate several of the current Geographic Service Areas.  When the new contracts go live in October of 2015, we’ll have a total of 3 service zones (North, South, & Maricopa) – rather than the current 6.  We’ve also ensured that tribal land aligns with the service areas.  Of course, tribes wishing to continue as a Tribal Behavioral Health Authority would continue as-is.  The solicitation makes it clear awardees will only be able to hold a contract in 1 service area.  We plan on reviewing the proposals beginning in October and awarding the contracts by the end of the year with an October 1, 2015 start date.

Opening the Doors to People with Special Needs: Solutions to Prepare Your Practice

July 11th, 2014

brother and sister enjoying day on playgroundOur Office of Children with Special Healthcare Needs has been working with UnitedHealthcare Community Plans and the AHCCCS to support an important free Conference on July 25 to improve the care delivery system in Arizona for children and youth with special health care needs and disabilities and their families.

The goal of the free Conference is to provide tools to primary care physicians, behavioral health providers and their staff to incorporate innovative best practice approaches as they care for children and youth with special health care needs and disabilities and their families.  It’s called “Opening the Doors to People with Special Needs: Solutions to Prepare Your Practice”.

The Conference offers health professionals an opportunity to interact with peers throughout the State acquiring continuing medical education (CMEs) and tools to take back to their practices as well as networking with community based organizations that promote health advocacy for individuals with disabilities across the lifespan.  Providers can attend in person or via Webex.  It’s easy to sign up and it’s free-including a complimentary lunch.

Please let your provider Stakeholder networks know about this important training event.

Opportunity to Join the Arizona State Hospital Team

July 5th, 2014

ash-job-fair-webThe Arizona State Hospital will be hosting a Job Fair next Wednesday (July 9) 9 am to Noon at 501 N. 24th Street, Phoenix.  We’re looking for folks that might be interested in joining our team at the Arizona State Hospital.  We’ll be recruiting for various positions like Psychiatric RN’s, Psychologists, Psychiatric Nursing Shift Supervisors, Mental Health Program Specialists, Psychiatrists, Recreational Therapists, Social Workers, etc.

The Fair is basically a one-stop shop…  and folks can interview for various positions in different areas of the Hospital.  We’re encouraging folks to please bring a resume, educational information and reference information.

Successful applicants go through a (paid) comprehensive 2-week program which includes training about our “Culture of Care”.   The 2 week training also includes a certification course in Non-Violent Crisis Intervention, which an evidence-based, best practice for early intervention and de-escalation created by the Crisis Prevention Institute.   Non-Violent Crisis Intervention is a proven-effective tool that provides a better therapeutic environment for patients and residents to live and improves safety for everyone.

Please forward this information to friends and colleagues that you think might be interested in one of the many different career opportunities at ASH.