Sir, You are Served

June 20th, 2011 by admin 1 comment »

There’ve been 3 lawsuits filed against the Department in the last few days.  On June 10th, the Arizona Biomedical Research Commission filed suit against the state (including me) to stop the enactment of the portion of SB1615, which transfers the Commission to ADHS next month.  We have someone from the Attorney General’s office working on this case.  We expect there to be some activity on this case shortly because the Commission was due to be transferred on July 21 (although there is a retroactive clause in the law to July 1).

Last Tuesday I was served with another lawsuit arguing that we should implement the dispensary portion of the Arizona Medical Marijuana Act.  On Wednesday I was served on a similar case also relating to licensing dispensaries.  Both of these cases ask the court to order us to follow the rules that we published on April 14 and begin accepting and processing dispensary applications.  As you’ll recall, the Governor and I (with the advice of attorneys) decided not to continue implementing the Arizona Medical Marijuana Act dispensary portions of the Act until we receive clarification about whether it’s legal from the federal court.  We’re still accepting and processing applications for Qualifying Patients and Designated Caregivers.  So far we’ve approved more than 6,000 Patient cards.

Monument & Wallow Wildfire Responses

June 17th, 2011 by admin No comments »

The center of gravity for the public health responses to the fires shifted South this week toward the new Monument fire.

Early this week folks were allowed to go back to Springerville and Eagar, which meant that it was show-time for Licensing again.  We sent a team of surveyors to re-open the licensed facilities that were evacuated last week.  All went well and everybody is back in business now.

Mid-week the Monument Fire (South of Sierra Vista) really took off, sending lots of smoke into areas south of Sierra Vista and into Bisbee.  Our licensing team has contacted well over 100 licensed facilities in the area to ensure that they have executable plans to safely evacuate their folks if it becomes necessary.  AHCCCS has also done a fantastic job working with the health plans to identify and help people in potentially evacuating areas that have complicated health conditions.  There are numerous other public health activities underway including monitoring air quality, behavioral health service continuity, food assistance and other activities.  As always, the latest response summaries are posted at www.azein.gov.  Well done everybody!

National Men’s Health Week is Here

June 16th, 2011 by admin No comments »

Men’s Health Week focuses on male specific diseases such as prostate cancer and men’s wellness in general, including mental health issues and accident prevention.

Many people think of their fathers this time of year – but men should at least make a commitment to themselves and their families to pay better attention to health and commit to age appropriate screenings.

Behavioral Health Facility Rules Overhaul: Step 1

June 15th, 2011 by admin 2 comments »

We kicked off Step 1 of our long-awaited overhaul of the behavioral health facility licensing requirements this week.  A new law passed last legislative session charges us with facilitating “licensure of integrated health programs that provide both behavioral and physical health services.”  The new law tells us to adopt rules relating to construction, equipment, sanitation, staffing for medical, nursing and personal care services, and record keeping pertaining to the administration of medical, nursing and personal care services, in accordance with generally accepted practices of health care.

Before we start drafting new rules, we’re anxious to get some ideas from stakeholders. This week we posted an electronic comment page to get input using Survey Monkey.  After we review the electronic comments we may meet with representatives of different types of facilities to discuss the current rules and gather more information.  If you are interested in participating, please provide contact information.

To help- here are the Current Rules.

Medical Marijuana Lawsuit Filed

June 14th, 2011 by admin 14 comments »

Today I was served with a lawsuit that challenges the State (and the Department) for not implementing the dispensary portion of the Arizona Medical Marijuana Act.  The case, filed in the AZ Court of Appeals, asks a judge to order us to follow the rules that we published on April 14 and begin accepting dispensary applications.

We worked very hard to implement the law until we received a letter from the U.S. Attorney in Arizona.  That letter, dated May 2, states the Department of Justice will:  “…continue to vigorously prosecute individuals and organizations that participate in activity…involving marijuana, even if such activities are permitted under state law.” “Individuals and organizations…that knowingly facilitate the actions of traffickers should also know that compliance with AMMA will not protect them from federal prosecution….”

With that information, the Governor and I (with the advice of attorneys) decided not to continue with full implementation of the Act until we receive clarification about whether it’s legal from the federal court.  We’ve suspended the implementation of dispensary portions of the law and aren’t currently accepting any applications.  As of today, we’ve had three groups try to apply for a dispensary certificate and we’ve turned them away.

We began accepting and processing applications for Qualifying Patients and Designated Caregivers several weeks ago and we’re still accepting and processing these applications.  As of June 9th, we’ve approved more than 5,000 Patient and 126 Caregiver cards.

Fed’s Release New Plan to Control Prescription Drug Abuse

June 14th, 2011 by admin 5 comments »

More than 1,100 Arizonans died from drug poisoning, which is more than the number of Arizonans that die in car accidents every year.  This isn’t just an Arizona public health crisis, it’s a national one.  Last week the federal government released a new plan to address the national prescription drug abuse epidemic and announced new Federal requirements aimed at educating the medical community about proper prescribing practices.

The report is called: Epidemic: Responding to America’s Prescription Drug Abuse Crisis and it provides a national framework for reducing prescription drug diversion and abuse by supporting the expansion of state-based prescription drug monitoring programs, recommending more convenient disposal methods to remove unused medications from the home, supporting education for patients and healthcare providers, and reducing the prevalence of pill mills and doctor shopping through enforcement efforts.

Mental Health First Aid

June 13th, 2011 by admin No comments »

Have you heard about Mental Health First Aid?  It’s designed to quickly help folks with a behavioral health need. It’s a lot like CPR or other forms of first aid for physical health conditions in that anyone can learn and apply the concepts soon after going through the short certification training.  Mental Health First Aid prepares folks to respond and act in a helpful manner when they’re concerned about someone’s mental health. This can be someone they know or even a stranger experiencing an emotional crisis.

To learn more and become certified in Mental Health First Aid, you’re invited to join one of the several 12-hour training courses taking place throughout our State.  Our new website provides details about all the classes available statewide (new classes are added continuously). If you live in Phoenix, you can also attend the June 13 training here at ADHS.

Behavioral Health Services in Maricopa County

June 12th, 2011 by admin No comments »

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.

Vital Records Self-sufficiency

June 12th, 2011 by admin No comments »

One of the budget bills that passed and was signed last legislative session (Laws 2011, Chapter 31, § 7) allows our Office of Vital Records to set new fees for copies of registered certificates, certified copies, amendments, etc. Our Office of Vital Records will use the new fees to “self-fund” the program, meaning we’ll no longer receive State General Funds to run the program.  Not only will this make us self-sufficient, but we’ll have the ability to invest in sorely needed technology infrastructure.  Our Rules, Finance, and Vital Records teams have developed the new proposed fees which are posted on our Rules website. The proposed start date for the new fees is July 1, 2011.

As usual, we’re asking for public comment about the proposed fee changes, and folks can send comments to Tom Salow at thomas.salow@azdhs.gov.  We’ll also be holding a public meeting to receive public comment about the fees on June 23, 2011 at 9:30 a.m. at 1740 W. Adams, Room 411A, Phoenix, AZ 85007.

Hospital & ACPTC Passes

June 11th, 2011 by admin No comments »

Over the weekend a resident of our Arizona Community Protection and Treatment Center (ACPTC) escaped while he was on an approved pass to go to church.  The resident was accompanied by one of our staff during the outing.  The resident was authorized to go on the pass to church because he had “LRA” or “Least Restrictive Alternative” status as determined by a judge, meaning that he had been entitled to some community outings.  Fortunately, alert, professional and creative law enforcement folks from the Tempe Police Department quickly followed leads and were able to apprehend the escaped resident by nightfall, and he’s been returned to our facility.  We’re investigating how the resident was able to escape and other circumstances that happened during the outing.

I asked the staff at the ACPTC and the Forensic Hospital to suspend the pass programs until we can assess what happened and to give us the time we need to review and revise our protocols for approving passes and setting the operational conditions under which they’re approved.  For example, we’ll be re-assessing the use of electronic monitoring devices (e.g. GPS tracking devices) as well as staffing ratios during passes.  We’ll also be reviewing other procedures such as setting up a protocol to notify police departments before somebody goes on a pass in their jurisdiction.

I know how important it is to give residents and patients an opportunity to experience life in the community and that passes are a critical component for Recovery and development of key skills.  Passes are also a critical legal component of our mission for folks that have achieved Least Restrictive Alternative status.  However, it’s also our responsibility to protect the community… and it can be tricky balancing passes with ensuring community protection.  I’m committed to resuming our pass program for our Forensic Hospital Patients and residents of the ACPTC, but not until we do a full assessment of the process and implement new procedures to ensure that the pass program doesn’t jeopardize community protection.