Rural Metro Bankruptcy Confirmed by Court (but not yet effective)

December 19th, 2013 by Will Humble No comments »

We received Rural Metro’s bankruptcy documents this week.  The Delaware bankruptcy court confirmed the company’s reorganization- including the business plan and capital structure.  The plan states that the company will be continuing all material contracts in AZ- which is good.  They’ll officially emerge from Chapter 11 once its reorganization plan is declared “effective”… meaning that all closing conditions are met. 

A primary closing condition that still needs to be met is a determination from the ADHS whether their Certificates of Necessity (CON) need to be transferred to the post-bankruptcy R/M entity.  If we determine that a transfer is necessary- we’d need to schedule a hearing (probably be this Spring) prior to transferring the CONs.  Such a determination would likely delay the effective date of the bankruptcy agreement- currently scheduled for January 7, 2014. 

Fortunately we have well-defined Statutes, Rules, and a Substantive Policy Statement to guide us in determining whether or not CON transfers will be necessary.  Now that we have the bankruptcy documents from the Court, we’ve begun our analysis of whether or not we need to hold a transfer hearing and transfer the CONs.  More to come soon. 

P.S.  We received the November update of Rural Metro’s response times this week.  The report shows continued marginal improvement- suggesting that the bankruptcy proceedings over the last several months have not substantially impacted response times in AZ.  However, we still have open investigations that we’re working on.

Arizona Public Health Association gets National Recognition

December 18th, 2013 by Will Humble No comments »

Congratulations to Arizona Public Health Association (AzPHA) for gaining national recognition for its work- snagging the 2013 National Affiliate of the Year Award from the American Public Health Association.

For 85 years, AzPHA has helped shape public health in Arizona working to create smoke-free environments and access to healthcare.  In this year alone, the Arizona affiliate reviewed more than a 1,000 legislative bills, visited AZ Congressional offices, put on professional development events and webinars and advocated for the restoration of Medicaid.  The current President, Patti Taylor, attributes the success to the membership, volunteers and partners.  I think it is also because of the leadership and dedication of the organization. 

AzPHA is a professional group that welcomes those who are interested in promoting public health in Arizona’s communities.  If you want to make a commitment to join, find out more online.


Next Stop On the Due Process Express

December 17th, 2013 by Will Humble No comments »

As Cory mentioned in his blog last week, the ADOA recently affirmed our award of the Maricopa County integrated behavioral health services contract to Mercy Maricopa Integrated Care and lifted the Stay on transition activities. The Order from ADOA marked one more step in the process of implementing an integrated care model for folks living with a serious mental illness in Maricopa County.  

Magellan elected to exercise their right to additional due process this week by filing a Motion in Superior Court asking for additional review of our and ADOA’s decision- and urging the court to Stay the transition until the review is complete.  In the mean-time, we’ll continue to work with Magellan on the day-to-day management of the current contract as well as continue to work with both Magellan and MMIC on more than 100 transition activities.


Solve the Outbreak 2.0

December 16th, 2013 by Will Humble No comments »

CDC just updated the free iPad app called Solve the Outbreak… which turns you into a virtual disease detective. The free app now has six newly released outbreaks. Get clues, analyze data and solve the case. Do you quarantine the village? Interview the sick? Do you run more lab tests before you draw conclusions and conduct interventions- or will the extra time used in the lab slow you down and give the disease a chance to get out of control? The better your answers, the higher your score – and the more quickly you’ll save lives. Here’s the website and how to register

There’s also another new disease detective game you can play online for free. It’s called Epidemic and it lets you investigate an epidemic by yourself- or like real-life- as a team. Epidemic was launched by the University of Minnesota School of Public Health and is designed to help people understand the role of public health. There’s even a teacher’s guide if someone wants to use Epidemic in the classroom.

Newborn Screening Turn-Around Times

December 13th, 2013 by Will Humble 1 comment »

An investigative article published by the Milwaukee Journal Sentinel a couple of weeks ago has triggered a state by state assessment of newborn screening programs across the country.  Arizona is no exception.   Our newborn screening and maternal and child health teams have been reviewing our procedures and looking for ways to improve Arizona’s performance. 

For example, several Arizona hospitals are under-performing when it comes to the timeliness of submitting newborn blood spot samples to our State Lab for testing. Last week, our Licensing team sent letters out to each of the birthing hospitals reminding them that they need to have solid policies and procedures in place to get their newborn screening samples to our lab promptly after they’re collected.  

Our laboratory team is in the process of planning some technical assistance visits to the hospitals.   We’ll also be setting up some training to make sure that all the hospitals know that our contract with FedEx for overnight priority pickup covers the entire state and won’t cost them anything to use.  I’ve set a goal for us to receive 95% of all samples in the lab within 3 days of collection- and we’ll be posting hospital turn-around times on our website quarterly- using transparency to drive better compliance.  We’re also developing a plan to run priority tests during 3-day weekends.  

Our Newborn Screening Advisory Committee also met this week.  We discussed our proposed newborn screening fee increase as well as whether we should add new tests to the panel in the future.  We haven’t made any decisions about whether to include new tests (and associated fees)…  but we’ll be reviewing the comments that we’ve been receiving as we prepare to make decisions in the coming weeks.

Arizona “Mission of Mercy” Starts Tomorrow

December 12th, 2013 by Will Humble 1 comment »

Seems like anytime you hear a 100+ year old person being interviewed about the secret to long life they say “take care of your teeth and feet and drink cod liver oil”.  For good reason.  Good oral health is critical to a person’s overall health. Tooth decay and gum disease are linked with heart disease, stroke and diabetes, and premature births. Many people in our community can’t afford dental care, so they suffer from poor oral health that affects their ability to speak, smile, smell, taste, touch and eat. That’s why the Arizona Dental Mission of Mercy is such an important event for Arizona.  

The event provides free dental services to people in need. Last year about 2,000 people were able to get services. This year’s Mission of Mercy takes place December 13 and 14 at the Arizona Fairgrounds. There’ll be about 100 portable dental units and 1,500 volunteers that will provide more than $1M in free care to children and adults. 

We’re supporting the event through Title V funds and several of our staff volunteered to provide health information about our programs and services to the patients. Thanks to Sheila Sjolander, Wayne Tormala, Jennifer Botsford, Tiana Galindo, Mary Luc, Cristina Ochoa, Margaret Lindsay, Anita Betancourt, Kimberly O’Neill, Mohammed Khan, Sharon Jaycox, Karen Sell, America Coles, Mary Ellen Cunningham, Belen Herner, Matthew Roach, Brandy McMahon, Blanca Caballero, Michael Abbott, Julia Wacloff, and Chris Minnick for volunteering for the event. 

Also, thanks to Maricopa County Public Health for providing flu vaccinations to participants- and a huge thanks to Kevin Earle, the Executive Director of the Arizona Dental Association for his leadership in setting up this year’s Mission.

Behavioral Health Contract Update

December 11th, 2013 by Will Humble No comments »

Our Behavioral Health team is working hard this month keeping up with all the changes and the transition.  Check out the Behavioral Health blog for an update.

Interested in Developing a “Family Health Portrait”?

December 11th, 2013 by Will Humble No comments »

We’ve known for a long time that your family health history can have a profound impact on your risks for certain inheritable diseases and illnesses.  Until now, there hasn’t been an easy way to track your family health history. 

The Surgeon General’s Office has developed an internet-based tool called “My Family Health Portrait” which makes it easy for you to record your family health history.  I’ve been told that the tool is easy to access on the web and simple to fill out- although I haven’t done it myself.  It assembles your information and makes a “pedigree” family tree that you can download. It’s a “private” tool in the sense that it doesn’t store or keep the information that you input.  

Using My Family Portrait allows you to: 1) enter your family health history; 2) print your family health history to share with family or your health care provider; and 3) save your family health history so you can update it over time.   Here’s where to learn more about the new tool.

Feet Slowing You Down?

December 10th, 2013 by Will Humble 18 comments »

The health of your feet is probably one of the most underappreciated yet important keys to your overall health. Each foot contains 26 bones, 33 joints, 107 ligaments, 19 muscles and associated tendons – all taking tremendous pounding over the years. It’s estimated that 75% of Americans will experience foot problems in their lifetime. While both men and women suffer from foot problems, it’s commonly cited by experts that women are more likely than men to have foot problems. 

According to the American Osteopathic Association, high heels are one of the biggest factors leading to foot problems in women, with up to 1/3 suffering permanent problems because of constant wearing of high heels. A recent study published in the Journal of Applied Physiology found that high heels can permanently change the way you walk (even without heels) and put you at greater risk for strain injuries. Chronic heel use can also result in ingrown toenails, nerve damage, bunions and irreversible leg tendon damage. The increased weight on your toes makes your body to move forward making you lean backwards and overarch your back, straining your knees, hips, and lower back possibly resulting in sciatica. 

Don’t let yourself get sidelined from physical activity because of preventable foot problems. For example, a bunion surgery can take 6 weeks to 6 months of recovery time. The National Foot Health Assessment survey showed that the percent of adults participating in physical activity is reduced almost in half if their foot health is rated fair/poor. 

Here are some helpful hints I found from the American Osteopathic Association to minimize the health risks from chronic heel-use: 

  • Choose shorter heels or flats more often. If you wear heels, pick ones that are less than 1.5 inches with a wide heel base;
  • Use insoles to reduce the impact on your knees;
  • Make sure your shoes are the right size so your foot doesn’t slide forward- which will put even more pressure on your toes. Pick a shoe with a wide enough toe box to let your toes wiggle;
  • Limit wearing heels on days when your schedule will include lots of walking or standing;
  • Alternate your shoe. Avoid wearing high heels all day by wearing flats during commute times; and
  • Take time every day to stretch your calf muscles and feet. 

Check out this slideshow on the worst shoes for your feet.

Request for Information (RFI) for the Greater Arizona “RFP”

December 9th, 2013 by Will Humble No comments »

Now that we’re on the road to transitioning to a new system of behavioral health care in Maricopa County, it’s time to move our sights toward taking our reform initiative to the rest of the State.  Our first objective is to get input from the public and other Stakeholders. 

That’s why we, in coordination with AHCCCS, released a Request for Information (RFI) this week.  We’re exploring the feasibility of contracting with more than one at-risk managed care organization to act as a Regional Behavioral Health Authority to create an integrated health care service delivery system to provide physical and behavioral health care services, and to maximize care coordination statewide (we’ve already started the transition in Maricopa County).  

The purpose of RFI is to seek input on the design of the service delivery system to be implemented in Greater Arizona and be fully operational by October 1, 2015.  The Request for Information asks a series of 15 key questions that will impact on how we formulate our next procurement solicitation for behavioral health services.  Folks can submit comments to Elena Beeman in our Procurement shop through January 22, 2014 to weigh in.