Arizona State Hospital New Forensic Unit On Track

August 26th, 2011 by admin No comments »

The new Arizona State Hospital forensic unit construction is on track and progressing nicely.  We’re in the home stretch now- and the contractors are putting the finishing touches on the project.  The new facility will be a huge help and will be much more conducive to helping our patients on their recovery path.  It’ll also really improve the working conditions for our dedicated staff- and will make their mission to help our patients alot easier.  Environment really does influence how well you can implement programming to help patients. 

The opening ceremony is scheduled for the first week in October.  Shortly after that, we’ll begin executing the transition plans developed by our transition teams and our patients will begin moving in to the new facility- which looks more like a college campus than a hospital.  The capacity of the new units will accommodate all of our forensic patients- although we’ll continue to operate the community re-integration unit out of the former adolescent treatment building.   

Later this fall the 50+ year old Forensic WICK Units will be shut down and mothballed.  By the way- the WICK Units were named after Samuel Wick, MD, who was the Superintendent of the Arizona State Hospital during the 1950s and early 60s.

Medical Marijuana Lawsuits

August 25th, 2011 by admin 1 comment »

We’ve had a few inquiries about the number, kinds, and the contents of the (six) lawsuits that have been filed regarding medical marijuana in Arizona.  We created a new Lawsuits webpage for folks that want to read the active suits.

PPAZ v. Humble et.al. Suit Resolved

August 24th, 2011 by admin No comments »

A recent lawsuit (Planned Parenthood of Arizona  v. Humble et.al.) was resolved this week.  The lawsuit had challenged a new law (signed last legislative session) that (among other changes) requires us to license facilities that perform medication abortions.  We already license and inspect facilities that do surgical abortions- the new law requires that facilities that perform “medication” abortions be licensed as well.  As background- when the original law passed that required the licensing of abortion clinics (in 1999) all abortions were in some way surgical. However, the standards of care have evolved and now there are as many medication abortions as surgical abortions in Arizona. 

Planned Parenthood filed a lawsuit a couple of months ago challenging a number of provisions in the new law.  Up until a few days ago it looked like we were headed for a series of depositions and hearings and a protracted dispute.  However, this week they had a change of heart and were motivated to settle. 

The suit was resolved when they agreed to withdraw their Application for Preliminary Injunction if a Stay Order would be placed on a few provisions related to the technical licensing requirements for medical abortions.  The bottom line is that our current rules for abortion clinic licensing were written when all abortions were surgical.  There are a few of our regulations that are important for surgical abortions but aren’t relevant for medication abortions because of the way they’re performed- so we were OK with excusing a handful of the surgical requirements (for facilities that only do medication abortions). The Plaintiffs agreed to drop all of the other former complaints in exchange for the agreement. 

This week’s agreement allows us to begin licensing and regulating any abortion clinics that provide medication abortions by September 13…  and our medical licensing team is poised and ready to add facilities to their list of work.  Thanks go out to Tom Salow and his team as well as our team of nurses in Medical Licensing for moving quickly this week to settle this matter.

Health Centers- a Key Hub for Primary Care

August 23rd, 2011 by admin No comments »

We’re proud to join in the celebration of National Health Center Week by highlighting Health Centers throughout our State and the vital services they provide. Community Health Centers are community-based, patient directed organizations that provide services to medically underserved areas.  These valuable safety net providers offer full-time comprehensive primary and preventative care to patients regardless of their ability to pay or their insurance status. 

Today there are 16 federally qualified health center organizations in Arizona with over 100 physical locations statewide.  They provide increased access to care to Arizona’s 46 federally designated medically underserved areas and populations.   The services provided by each center are adapted to address the major health care needs of their target population and to ensure the availability and accessibility of essential primary and preventive health services, including, oral health, mental health, and substance abuse services.  By maximizing the availability, access, and continuity of primary care services, health centers play a critical role in improving the health care status of medically underserved and vulnerable populations.    

One of the many ways that the ADHS supports health centers is through our Bureau of Health Systems Development.  Our team provides technical assistance, data, reports, maps and other tools to established health centers as well as facilities applying to become health centers through its Community Development Program.  We’re working closely with the U of A’s Rural Health Office to provide a free webinar series covering Issues in Rural Health Planning.  To find a health center near your home, check out HRSA’s electronic search engine.

AZ Well Woman HealthCheck Program Get’s High Marks

August 22nd, 2011 by admin 1 comment »

Most of us are aware that the Well Woman HealthCheck increases screening for breast and cervical cancer.  As part of our federal funding agreement for the program the CDC audits 100% of the services provided.  Services are audited for appropriateness and timeliness- even the age of women receiving mammograms is audited for meeting guidelines.  We submit program data to CDC twice per year and get a report card back on our performance.  

Our latest  report card showed that we “met or exceeded” all core quality indicators while screening 7,700 women for breast cancer and over 5,200 women for cervical cancer in 2010.   Why is this important?  We know women in the program are receiving appropriate care within evidence based guidelines.  It’s also important because the program has a performance based budget.  In today’s environment it means that the budget is held level with no reductions.  The program’s contractors and staff deserve congratulations for the excellent work to maintain a high level of quality.

AZ Physicians Referred to Licensing Boards due to Questionable Medical Marijuana Certifications

August 19th, 2011 by admin 22 comments »

One of the criteria on our official medical marijuana Physician Certification Form includes an attestation by a physician that they’ve reviewed their patient’s profile on the Arizona Board of Pharmacy’s Controlled Substances Prescription Monitoring Program database before signing the certification.  We included this requirement to ensure that physicians are acting in their patient’s best interest- and making sure that they’re using best practices and checking to see whether their patient has been prescribed other controlled substances before signing the marijuana certification.  Another requirement that we included asks physicians to attest that they’ve reviewed the patient’s medical history including examining the last 12 months of the patient’s medical records before signing.  We also think these requirements are important because other states that have medical marijuana programs have found that some physicians are more focused on getting revenue from signing certifications than on their patient’s health.

As a routine quality check in our certification system, we’ve been asking the Board of Pharmacy to verify whether or not certifying physicians are actually accessing the system (as they have attested).  We’ve identified 3 MDs and 5 Naturopaths that have been routinely attesting that they’ve checked the Controlled Substances Prescription Monitoring Program when they appear to have not checked that regularly.  Dr. Nelson and I sent letters to their licensing boards recently notifying them that it looks like these 8 physicians may be falsely attesting that they’re checking the Prescription Monitoring Program database.  In each case, they appear to have written more than 100 certifications (some several hundred) that included attestations that cannot be verified by the Board of Pharmacy.

Our larger concern is that if these physicians aren’t completing this simple requirement (and making false attestations)- it’s likely that they’re taking other short-cuts that may be jeopardizing their patient’s health- such as not reviewing the patient’s medical history before writing medical marijuana certifications (also required in the series of attestations).  Since these 8 physicians have signed nearly half of the 10,000 medical marijuana medical certifications, we think it’s important that the boards know about this so they can decide if the physician is acting in the patient’s best interest.  The referrals may also have a side effect of discouraging physicians from writing recreational certifications.

Active & Safe Routes to School

August 19th, 2011 by admin 1 comment »

School is back in session- which means it’s time to figure out your family logistics for getting to and from school. Fortunately, we have a new tool to help families make the healthy choice and consider an “active” solution.  We just launched our new online assessment tool called the Active School Neighborhood Checklist to help families make safe and healthy school transportation choices.  

We’re also partnering with the Arizona Department of Transportation Safe Routes to School Program to develop a tool that generates a score which represents the walk-ability, bike-ability and safety of schools.  The results of this assessment will help communities, school facilities professionals, schools, and city officials identify barriers that prevent students from walking and biking to school each day and create solutions to encourage neighborhoods to be more physically active.

Recovery Works!

August 18th, 2011 by admin No comments »

The August issue of Recovery WORKS! is now available in our website.  Check it out…there are several new features including a recurring column called “Peer-Run Organizations Profiles” that will briefly highlight the tremendous work by our peer-runs; and the new “State Chatter” box which will share a variety of news from peers, family members, and general behavioral health stakeholders from around the state.

Behavioral Health Services Block Grant

August 17th, 2011 by admin No comments »

Our Behavioral Health team has completed the draft of our ($27M) 2012-2013 Joint Block Grant Application for Mental Health and Substance Abuse Prevention and Treatment Services. This year SAMHSA streamlined the application process to allow States to apply for grant funds under one combined application and has moved away from a standardized reporting template, allowing the States to determine their own needs and service directions.  Our (150 page) application has been posted for public comment (through August 26) on our grant application website.  Folks can provide comments to grantsmanagement@azdhs.gov.  

States use this Block Grant for prevention, treatment, recovery supports and other services that will supplement services covered by Medicaid, Medicare and private insurance. For example, we use block grant funds to fill in for priority behavioral health treatment and support services for folks without insurance or for services not covered by Medicaid, Medicare or private insurance.  Block grant funds also go toward primary prevention services like universal, selective and indicated prevention activities and services.

Trauma System Milestone

August 16th, 2011 by admin No comments »

One of our Department priorities over the last few years has been to improve Arizona’s Trauma System.  We know we can dramatically improve service and reduce costs by developing a coordinated and integrated system of trauma care for the entire state.  More than 24,000 people are severely injured (called trauma) every year in Arizona, and more than 60% of these severe injuries occur in the rural and frontier areas of Arizona. Receiving treatment in this first hour is critical to survival.

We completed a full assessment of Arizona’s trauma system a few years ago and concluded that our greatest weakness was our rural and frontier Arizona trauma capacity.  Our priority has been to establish Level IV Trauma Centers in rural AZ hospitals so that folks can be treated closer to where they’re hurt- or to be resuscitated and stabilized so they can be transported (preferably by ground) to a higher level of care if necessary.  Designation as a Level IV requires the least resources and capabilities and typically will resuscitate and stabilize a patient and transfer the patient to a more appropriate Level, based on the patient’s injuries.  We started small- with a couple of early adapter hospitals coming on line as Level IV trauma centers.

Our team has stuck with it- and this week we welcomed Wickenburg Community Hospital to our family of 13 Level IV Trauma Centers. We now have a vastly improved network of trauma resources in rural Arizona.  We’ll continue to press ahead to recruit additional Level IV Trauma Centers in rural AZ- but also to recruit 2 or 3 Level III trauma centers in select rural communities that can care for moderately injured patients whose injuries are severe enough that our Level IV centers can’t care for them, but who don’t require the specialized care that is available from the Level I trauma centers.