Posts Tagged ‘Behavioral health’

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

April 22nd, 2014

dividendsOver the next couple of weeks I’ll continue 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. Last week I wrote about the Integrated Health Homes initiative.

Another success has been improvements in our Crisis Response System.  In Maricopa County, Magellan, with providers and partners, restructured and overhauled the system to reduce congestion at emergency rooms- decreasing the amount of time first responders spend processing an admission to behavioral health acute care service from 2.5 hours to 7 minutes.  A strong performance by any standard.  Next week, I’ll cover improvements to the kids system of care.

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.

Improving Arizona’s Birth Outcomes

March 13th, 2014

Arizona ranks in the middle of the pack in infant mortality.  We’re doing many things right to improve the health of our babies-  but we have a way to go. Last fall we participated in a learning collaborative sponsored by the National Governors Association.  About 160 folks met to begin the process developing a statewide plan.  They included physicians, public health, nutrition, behavioral health, city planners, business leaders and many more. 

After looking at the data on the health of Arizona’s women and children and reviewing some best practices from around the state, participants broke into groups to talk about the issues and to develop strategies to address these issues. These strategies will be the foundation for the statewide plan to improve birth outcomes.  

Our next step is to form workgroups to develop action plans for the different strategies identified. You can look at the presentations from the day and learn more about our efforts by going to the Healthy Babies web page. Many people have volunteered to be a part of these workgroups and have signed commitment forms.  It’s important to know that this is not an ADHS plan but Arizona’s plan.

Public Health Initiatives for Refugees in AZ

January 28th, 2014

Last year 3,663 refugees resettled in Arizona from 45 different countries (about 1/3 were from Iraq).  Refugees have a variety of pressing social, economic and health needs when they arrive. That’s where our ADHS Refugee Health Program comes in.  Our Refugee Health Coordinator, Zachary Holden, works with partners to ensure that refugees arrive healthy and maintain good health as they establish their new lives in Arizona.  It’s part of an initiative through the DES’ Refugee Resettlement Program

Folks from across ADHS in communicable disease, chronic disease, environmental health, behavioral health, injury prevention, and women’s and children’s health have provided educational materials, which have been translated into the top 12 refugee languages. Our Refugee Health website also includes information for case managers, like guidance on common challenges for refugee populations; community profiles for healthcare providers, and community information about organizations who serve refugees.  We’ve even done some data analysis to examine health trends in refugee populations to better target care and prevention education. 

You can check this information hub to better arm yourself with the cultural and linguistic tools to make a positive impact on the health of this unique population.

What’s the Medical “Standard of Care” in an Emergency?

January 23rd, 2014

Good question.  Disasters and public health emergencies can stress health care systems to the breaking point and disrupt delivery of vital medical services. For example-  hospitals and long-term care facilities may be without power; trained staff, ambulances, medical supplies, and beds could be in short supply; and alternate care facilities may need to be used. 

You can imagine how difficult it would be to set alternative standards of care in the middle of an emergency- which is why we’ve been working with a statewide Crisis Standards of Care planning group since last January.  Our Public Health Emergency Preparedness team has been working with healthcare, public health, emergency management, and legal experts to develop a plan and a set of standards to guide the delivery of healthcare during the most catastrophic disasters- providing guidance for managing scarce resources (both people and stuff) in an emergency. 

A key resource is a landmark crisis standards of care report developed by the Institute of Medicine- which examines indicators and triggers that guide the implementation of crisis standards of care and provides a toolkit to help stakeholders establish indicators and triggers for their own communities.  The IOM report has toolkits for behavioral health, emergency management, emergency medical services, hospital care and public health.

Behavioral Health Efficiency Moves

January 9th, 2014

This week we’re making 3 efficiency changes in our behavioral health system.  Instead of having providers bill us and AHCCCS for different services, all the bills will go to AHCCCS- and we’ll get statements from them.  It’ll be the same with enrollment- all paperwork is processed through AHCCCS and we’ll get a standard report that will keep the system up-to-date.  The 3rd change should make it more efficient for determining whether someone has a Serious Mental Illness in the greater Phoenix area.  The Crisis Response Network will evaluate the information based on our standards. 

Once again – thanks to the amazing number of people who came together from IT and Behavioral Health to make these changes a reality including Ravi Pitti, Geetanjali Bandi, Nasrin Akhter, Laxma Veeravelly, Desi Grosso, and Vickie Kropp, Kumar Mani and Serghei Scafaru.

 

Behavioral Health Contract Update

December 11th, 2013

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.