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.
Posts Tagged ‘Behavioral health’
Objective evaluation is critical to assessing and improving the performance of any public health system- including the behavioral health system that we manage. One of the ways we assess our behavioral health system is to conduct a “Quality Services Review”, which identifies strengths, service capacity gaps, and areas for improvement at a system-wide level.
A couple of weeks ago a final Quality Service Review was published for our Maricopa County service area for folks living with a serious mental illness. The final report summarizes the services provided and not provided, access to care, selected outcomes, conclusions, and recommendations. The report indicated both positive trends in the current system of care as well as opportunities to enhance the system.
The report found both strengths and weaknesses in our system. Strengths included a finding that services provided matched the individuals’ needs identified on their Individualized Service Plan 82% of the time. About 88% of individuals surveyed agreed that their service location was convenient and 84% agreed that service times were convenient. Individuals reported that about 81% of services were provided within 30 days once a need was identified.
Areas that need some work include progress notes. Individuals’ needs in their assessment were consistent with the needs identified in the progress notes in about 59% of the cases. About 69% of surveyed folks were reported that they were involved in meaningful daily activities. While 95% had housing, only 9% were employed. Respondents also reported the need for better service in the areas of supported housing and employment, living skills, family and peer support. Of course- what I’ve described here is just a snapshot- and the full report provides a lot more detail.
We’ll be using the results of this Quality Service Review as well as follow-up analyses to help us as we continue to improve public health outcomes for folks living with a serious mental illness. This was the first time that we used this type of system assessment… and we’ve discovered a few areas that we need to improve in the tool. We’ll be working with the contractor to make sure that the continuing version of the Review captures all the information we need to make a solid system assessment.
In our April issue of Recovery WORKS you’ll find inspiring recovery stories, behavioral health news, resources, and information from our community. Our featured peer success story this month is about MedHat Zekri, a peer who’s been able to overcome severe depression, anxiety and stress and is being very successful in achieving his life’s goals. In our “Healthy Living” section you’ll find information and tips for enjoying a healthy lifestyle with focus on eye safety. In our “Dimensions of Wellness” section you’ll see information about the “Financial Dimension of Wellness”.
Each issue explores one of the 8 dimensions of wellness and provides ideas and resources to help address that particular dimension of wellness in your life. We hope you’ll continue to find inspiration, encouragement, and practical knowledge through this publication. Here’s how to sign up to get future issues.
We’re getting near the end of the long journey of our licensing regulatory reform. Last Wednesday we posted the revised draft rules for Chapter 10 (Health Care Institutions – Licensing) and Chapter 20 (Non-licensing approval). Our goals is to simplify and streamline our rules so they align with our strategic plan and map to improve public health outcomes. We’ve been working with representatives from the medical community, the behavioral health system, advocates and other affected folks to help reform our regulations. We still need your help. Please provide comments for Chapter 10 using online surveys . Please provide comments for Chapter 20 using online survey .
The comment period will end on May 5th. The Department will revise the drafts and the final rules will take effect on July 1st of this year. Please visit our Licensing webpage to learn more about our integrated licensing rules implementation.
Thanks to all who have helped to advance the licensing of integrated health in Arizona!
No doubt the word “ Sequestration” is front and center in your vocabulary these days. This is just a quick note to forecast how it might impact our mission. For starters… the main impacts from federal sequestration (i.e. the federal budget reduction for some programs) will be related to the services that we provide and the planning that we do related to our federal cooperative agreements and grants. The primary agencies that award us funding are within HHS (CMS, HRSA, CDC, SAMHSA) and USDA (WIC). Not all federal programs are subject to the federal budget reduction that will go into effect shortly.
For example, the behavioral health services that we provide via Medicaid are largely exempt from the reductions… but most of our cooperative agreements and federal grants are subject to the reductions. We receive a total of about $255M in federal funds that look like they’ll be subject to reductions for the remainder of this federal fiscal year. WIC is the biggest chunk, at about $161M (or 63% of our total grant funds affected).
How we manage these reductions will vary depending on how much flexibility the parent federal agency gives us. As we make these decisions, we’ll consider grant variables… like how much of the award we’ve spent so far this fiscal year and whether the grant is mainly service dollars or strategic planning etc. For some programs we may be able to identify under-performing areas of the grant or agreement and focus our adjustments there.
For example: Karen Sell’s WIC team has done a fair amount of planning already to mitigate the immediate and even mid-term impact… like changing the food package starting July 1 (adopting less expensive brands) and identifying some current unspent funds. We won’t need to put WIC applicants on a waiting list for at least a month… but depending on how things go, we may need to start a list later in the year.
I’ve asked the executive management team to work with each of the programs that look like they’ll be affected and start the planning process for making the reductions- focusing on identifying ways that we can make reductions that will minimize impacts in the field (like the way WIC will be moving to less expensive food brands). Anyway… stay tuned. Things at the federal level look like they’re still in flux. The more nimble and creative we are the better off our mission will be.
Our Vision at the Arizona Department of Health Services is, ”Health and Wellness for all Arizonans.” Part of our mission includes helping individuals with substance abuse issues achieve and maintain self-reliance and independence. To get there, some individuals simply need occasional outpatient services. Some need wrap-around, community or home-based services. Others require more intensive treatment in a residential setting. Our goal is to provide the most effective kind of treatment to suit every individual’s unique needs. While no two paths to recovery will ever be identical, we do know this: young people recover better in settings as close to home as possible.
Over the past two years, we’ve taken that knowledge to heart – and our actions have paid dividends. We’re matching more people with effective wrap-around services like in-home counseling, high-needs case management, home-care training, peer support, respite, family support and skills training. In turn, we’ve reduced the need for care in licensed high-level Residential facilities by 75% in Maricopa County. However, outpatient treatment, home and community-based services can’t always provide the level of treatment people need. Some individuals require more intensive treatment that only a licensed and regulated residential facility can provide.
A series of reports in The Republic this week suggests that some juvenile residential treatment facilities in our state are substandard. While no facility is perfect, our inspectors are well-trained and highly-motivated to ensure each of our licensed residential treatment facilities meets State standards. Those that fail to meet these standards must implement an immediate corrective action plan.
We inspect residential treatment facilities at least once a year — more often when we receive complaints. When we inspect facilities, our teams make decisions based on evidence. We talk to the residents and the staff; we look at patient and personnel records (including video records); we observe facility practices and examine physical evidence. This helps us separate legitimate complaints and concerns from those that are baseless or intentionally fabricated. We receive dozens of incident reports every day, which we carefully and promptly evaluate. It’s unusual that a report poses a health or safety problem. But when a situation that does is brought to our attention, we immediately send staff to the facility.
Successful residential treatment facilities are pro-active, follow their policies and procedures without fail, are meticulous in reporting and documentation and seek ongoing education. They’re not afraid to admit a mistake. Our job is to ensure that facilities comply with our standards and maximize their effectiveness. That’s why our licensing teams also focus on ways to improve our licensed facilities and our Behavioral Health team focuses on the evidence-based treatment that’s best for the patient. Additionally, we’ve been overhauling many regulations to ensure our standards focus on the most important components of care.
Our actions as an agency must be based in fact and rooted in the evidence demonstrated by a comprehensive review of the facility in question. You can view factual information about the more than 7,400 facilities we license by visiting www.azcarecheck.com.
Our Vision at the Arizona Department of Health Services is ”Health and Wellness for all Arizonans”. Part of that Vision for folks living with behavioral health issues or a mental illness means achieving and maintaining self-reliance and independence. To get there, some individuals simply need outpatient services occasionally. Some need wrap-around community or home-based services. Others need more intensive treatment in a licensed residential setting. Our goal is always to provide the most effective kind of evidence-based treatment for that person.
For example, our home and community-based wrap-around services have been so effective that we’ve reduced care in licensed high-level Residential facilities by 75% in the last couple of years in Maricopa County. We did this by building up home- and community-based wrap-around services like in-home counseling, high needs case management, home care training, peer support, respite, family support, and skills training. However, outpatient treatment and home and community based services can’t always provide the level of treatment folks need, and some people need the more intensive treatment that only a licensed and regulated residential facility can provide.
A series of reports in the Republic this week suggests that some residential treatment facilities in our state are substandard. While no regulated facility is perfect, our teams of inspectors are well-trained and highly-motivated to ensure each of our licensed residential treatment facilities meets our standards. Those that don’t must implement an immediate corrective action plan. Additionally, the DHS team has been overhauling many of its regulations to make sure our standards focus on the most important components of care.
We inspect residential treatment facilities once a year, and more often than that when there are complaints. When we’re inspecting facilities, our teams make decisions based on evidence. We talk to the residents and the staff; we look at patient and personnel records (including videotape); we observe facility practices and examine physical evidence. We require two forms of evidence to substantiate an issue. This practice helps us separate legitimate complaints and concerns from those that are baseless or intentionally fabricated.
We also receive dozens of reports every day as part of our regulatory oversight of all of our licensed facilities. We carefully and promptly evaluate each report and respond accordingly. Many of the reports that we receive are routine and pose no health or safety problem. When we receive a report that could pose an immediate safety concern, we send staff to the facility immediately like we did with an assisted living facility over the weekend.
Successful residential treatment facilities are pro-active, follow their policies and procedures without fail, are meticulous in reporting and documentation, and seek ongoing education. They’re not afraid to admit a mistake. Our job is not just to ensure that facilities comply with our standards, but also to maximize their effectiveness. That’s why our licensing teams also focus on ways to improve our licensed facilities.
Unlike newspaper reporting, our actions as an agency must be based in fact and rooted in the evidence demonstrated by a comprehensive review of the facility. Folks can view factual information about the more than 7,400 facilities licensed by the Arizona Department of Health Services by visiting www.azcarecheck.com.