Posts Tagged ‘Serious Mental Illness’

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

April 30th, 2014

Over the past couple of weeks, I’ve reflected 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.  So far, I’ve covered integrated health homes and improvements to the crisis system.

On the kids front, more than 1,500 Maricopa County youth who experience behavioral health challenges have benefitted from participating in “MY LIFE” (Magellan Youth Leaders Inspiring Future Empowerment).  Through this group- members get support from their peers and develop critical skills in leadership and mental health resiliency.  Their activities have been invaluable in the fight against stigma associated with behavioral health issues.

Minors in the juvenile justice system in Maricopa County have had access to culturally relevant substance use and disorder treatment programs.  Sixty-four percent of the participants in the 21-month program decreased or eliminated their substance use- and more than 70% report completing treatment without returning to the juvenile justice setting.  Magellan earned the SAMSHA Science and Service Award for implementing this program.

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.

Today’s Arnold v. Sarn “Fairness Hearing” a Success

February 27th, 2014

A few weeks ago the Governor announced a final agreement had been reached in the 32 year old Arnold vs. Sarn case regarding care and services for individuals with serious mental illness. The Settlement is the foundation to end the lawsuit while establishing a blueprint for a successful community-based behavioral health system in Arizona. 

This morning we had a fairness hearing in Maricopa County Superior Court on the case. The Governor and I were among the speakers.  The hearing went well, and at the end, Judge Bassett entered an Order from the bench that accepts the Settlement Agreement. Under the terms of the stipulation approved by the Court today as fair and reasonable, Arizonans with serious mental illnesses will be assured of enhanced community-based services that allow them to participate in society in a meaningful way, including: crisis services; supported employment and housing services; assertive community treatment; family and peer support; life skills training; and respite care services. Additionally, the stipulation includes metrics, national standards and evidence-based best practices to ensure quality, transparency and accountability in Arizona’s mental health system. 

We expect to have a dismissal hearing later this year- which will officially end the Arnold vs. Sarn lawsuit that was filed in 1981. Of course, we’ll still be expected to live up to the terms of the Settlement- which is among our Agency’s top priorities.

Next Stop On the Due Process Express

December 17th, 2013

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.

 

Integrated Care Responses On Deck

January 8th, 2013

We all need to take care of both our physical and behavioral health needs in order to be healthy. The mind and body aren’t separated- and neither should the health-care delivery system- especially for folks with a serious mental illness. Folks with a serious mental illness die more than 25 years earlier than the general population… an unacceptable health disparity in anybody’s book. The increased mortality is largely from treatable medical conditions caused by modifiable risk factors like smoking, obesity, substance abuse, and not accessing primary and acute medical care. Population health issues. 

We recognized the need to address this unacceptable health disparity when we put together our Strategic Map and Plan that includes integrating behavioral and acute healthcare. It’s been a long haul and a lot of work- and we passed a major milestone today when folks submitted their bids on our Request For Proposal (otherwise known as RFP) for the delivery of behavioral health services in Maricopa County.  We received bids from: 1) Magellan Complete Care of Arizona, Inc.; 2) Cenpatico of Arizona LLC; 3) Arizona Physicians IPA, Inc. (APIPA), d/b/a UnitedHealthcare Community Plan, operating as UnitedHealthcare Whole Health; 4) Mercy Maricopa Integrated Care; and 5) Partners in Integrated Health, LLC. 

Our evaluation team will begin their analysis shortly…  and we expect the evaluation process to take 8 weeks or so.  The entity that ends up getting the contract will be responsible for delivering both preventative, acute and primary care along with Recovery-based behavioral health services for folks in the public behavioral health system in Maricopa County beginning on 10/1/13.  

It’s difficult to put into words how much work has gone into this solicitation. I know that many of you put this work on top of all your normal work, had put off other projects, and sacrificed some of your home-life for this product- and I just really want you to know that I appreciate it. It’s going to save lives. Stay tuned.

Integrating Physical & Behavioral Health Services to Save Lives

October 11th, 2012

We all need to take care of both our physical and behavioral health needs in order to be healthy. The mind and body aren’t separated- and neither should the health-care delivery system- especially for folks with a serious mental illness. Folks with a serious mental illness die more than 25 years earlier than the general population… an unacceptable health disparity in anybody’s book. The increased mortality is largely from treatable medical conditions caused by modifiable risk factors like smoking, obesity, substance abuse, and not accessing primary and acute medical care. 

We recognized the need to address this unacceptable health disparity when we put together our Strategic Map and Plan. It’s been a long haul and a lot of work- and we passed a major milestone this week when we released our Request For Proposal (otherwise known as RFP) for the delivery of behavioral health services in Maricopa County. The entity that ends up getting the contract will be responsible for delivering both preventative, acute and primary care along with Recovery-based behavioral health services for folks in the public behavioral health system in Maricopa County. The new contract is scheduled to start on 10/1/13. 

It’s difficult to put into words how much work has gone into this solicitation. I know that many of you put this work on top of all your normal work, had put off other projects, and sacrificed some of your home-life for this product- and I just really want you to know that I appreciate it. It’s going to save lives. You can check out the full solicitation on the State’s Procurement website hub- called ProcureAZ.

Watershed Week for Behavioral Health Services

May 17th, 2012

The Governor and I and the plaintiffs in the 1981 Arnold v. Sarn lawsuit signed a landmark agreement today which will last 2 years (pending the court’s approval).  Today’s agreement outlines objectives for supported care and services for folks with a serious mental illness.  Over the next couple of years we’ll work together with the plaintiffs to enhance Arizona’s behavioral health system with a focus on a Recovery model built on community supports like skill-building, self-management of health conditions, coaching, community-based peer and family support, employment, and community integration.  We’re also pleased that the new agreement incorporates national best-practice models and standards. 

Today’s agreement also ties into the additional $38.7M we received in the budget that was recently signed.  That funding is for community-based, recovery-oriented behavioral health services for folks with a serious mental illness that don’t qualify for Medicaid (AHCCCS).  Our next task is to build our investment plan for those funds- and that means getting solid Stakeholder input to help us make important advancements in our service delivery and to demonstrate Arizona’s commitment to using effective community-based services and supports that allow individuals with serious mental illnesses to live successfully in their own homes and communities. 

We’ll be hosting several stakeholder meetings next week to share our thoughts and hear ideas and proposed approaches on the best use for this funding.  Our meeting with our Tribal and Regional Behavioral Health Authority partners will be on next Tuesday and our meetings with behavioral health providers, including peer and family-run organizations that serve individuals with serious mental illnesses will be next Wednesday.  You can see more detail in Dr. Nelson’s Stakeholder Letter.

 

Inside the Governor’s Budget

January 25th, 2012

Dr. Nelson wrote a great blog this week that discusses the behavioral health aspects of the Governor’s

2012 State of the State Address which was followed by the release of her policy agenda called The Four Cornerstones of Reform: Centennial Edition.  Please visit Dr. Nelson’s blog for the details of the Governor’s remarks about behavioral health including information about the FY2013 Executive Budget which proposes almost $39M in additional funding be set aside for certain community-based services for folks struggling with a serious mental illness (who don’t qualify for Medicaid)…  for things like peer and family support, supported employment, supported housing, health promotion, and living skills training.  This is great (and welcome) news. 

There are a number of other elements related to our Agency budget proposal in the budget report- including a provision that would allow us to set appropriate fees for our newborn screening program, which has been running in the red for the last couple of years despite aggressive cost-cutting measures.