Posts Tagged ‘seriously mentally ill’

Historic Arnold vs. Sarn Agreement Reached

January 8th, 2014

The Governor today announced a final agreement has been reached in the Arnold vs. Sarn case regarding care and services for individuals with serious mental illness.  Litigation that commenced in 1981, the settlement ends a more than three-decade long lawsuit against the state and establishes a blueprint for a successful community-based behavioral health system in Arizona.   You can read more about the Agreement and get links to the documents filed today on Cory Nelson’s blog.

SMI Eligibility Determination RFP

February 13th, 2013

We just issued a Request for Proposal to find a contractor to make eligibility determinations regarding whether or not folks meet the criteria for determination as seriously mentally ill (SMI) in Maricopa County.   The idea is to have an objective process for eligibility determinations by contracting with an independent entity.  The contractor will be responsible for decisions regarding eligibility determinations, including all the administrative responsibilities.  Proposals are due date March 7, 2013 at 3:00 p.m. on ProcureAZ.  Once proposals are submitted, a committee will review the proposals and a new contract will be awarded (starting October 1).  Here’s the Bidders Library and Documents Incorporated by Reference (under “ADHS13-00002633 – Serious Mental Illness Eligibility Determination for Behavioral Health).

Behavioral Health Annual Report

January 10th, 2013

Our Behavioral Health Services team just finished and published our FY 12 Annual Report.  The new report identifies the number of clients served by service area, funding category and program; and includes programmatic financial reports of revenues, expenditures and administrative costs.  In it, you’ll see that we received a total of about $1.46B in funding for FY 2012 for behavioral health services.  Our Agency administrative costs were about 1% of the total (about $18M). 

The report shows our revenues and expenditures (including specific identification of administrative costs) for each behavioral health program category (The Seriously Mentally Ill; Alcohol and Drug Abuse; Severely Emotionally Handicapped Children; Domestic Violence; and the Arizona State Hospital).


Public Health Budget

May 9th, 2012
 The Governor signed the budget this week – here’s a look at how some of it affects public health:

Behavioral Health Services for folks that don’t Qualify for Medicaid

The budget that was just signed includes about $39M in new funding for services for folks with a serious mental illness that don’t qualify for Medicaid.  With it, we’ll be able to provide some services like supported employment and housing, peer and family support, living skills training, and health promotion to help folks along their Recovery journey.  We’ll also be expanding the list of medications for the folks with a serious mental illness so it matches the list for folks that qualify for Medicaid.  Our behavioral health team has already begun working closely with the RBHAs, providers, and members/families to plan for the most effective use of this funding.

Newborn Screening

Our newborn screening program has been running in the red for the last couple of years- despite the fact that we’ve squeezed just about every efficiency out of the program and are collecting more than 95% of our service fees.  The current screening fee is $30 for the 1st (hospital) screen and $40 for the 2nd (which happens in the pediatric office a couple of weeks after birth).  These fees haven’t been raised in several years- meanwhile the instruments and reagents we use have become increasingly expensive.  We’ve been supplementing the program with Title V funds that really should be used for other more effective purposes. The budget that was just signed allows us to set new fees for the 2nd screen in Rule…  and we’ll be starting that process shortly.

County Contribution toward Hospital Patients and Residents

The “Budget Reconciliation Bill” or BRBs included specific instructions regarding how much counties are obligated to pay (50%) for the patients and residents at the Hospital and ACPTC (the sexually violent person’s unit).

ASH Administration building

Hospital Operating Fund

Despite all our efforts to reduce overtime, cut shift overlap, streamline services and other efficiency measures- our hospital operating fund was headed for big trouble next fiscal year- partly because the Hospital Fund (which had provided funds to operate the Hospital) went dry. The state budget that was just signed rescued us from needing to cut our staffing ratio’s to below Licensing standards (which would have put us in jeopardy of losing Medicare and Medicaid funds).  Whew.

Peer & Family Behavioral Health Report

February 28th, 2012

We recently held a series of focus groups and interviews to obtain input from persons with Serious Mental Illnesses (peers) and their family members regarding the integration of physical healthcare and behavioral healthcare services in partnership with St. Luke’s Health Initiative and AHCCCS, and several behavioral health peer-run organizations and peer and family members.  The full report is now available online and is titled: “Summary of Input from Peers and Family Members Regarding the Planned Integrated Healthcare System for Persons with Serious Mental Illnesses”.  It’s on our Integrated Behavioral Health and Primary Care website under the NEWS area along with a link where to submit additional input and the latest information regarding integration. 

I won’t spoil things by saying too much about the results- but I’ll give you some “key words” from the report: Listen, Voice, Respect, Individualized, Skilled, Quality, Outcomes, & Equity.

Working Together for Health & Wellness

September 21st, 2011

We’ve had to make lots of difficult decisions in response to the ongoing funding shortfalls in our behavioral health system (as well as everywhere in state government).  Many decisions (while painful in the short term) have been necessary to maintain long term system stability as Arizona continues to emerge from this unprecedented fiscal crisis.  While Arizona is gaining ground economically, the progress is slow and requires ongoing, innovative approaches and strong collaboration by all behavioral health system partners.  Because of our partnerships- our system remains strong. 

State government has been working hard to protect coverage and services for individuals with behavioral health needs.  A recent public letter from Dr. Nelson outlined some of our innovations to creatively reinforce our behavioral health system.  We’ve needed to reduce behavioral health provider reimbursement rates, but we’ve taken other actions to help out behavioral health providers and folks that receive services.  For example, we increased the percentage that must be spent on services and decreased the amount of profit behavioral health authorities are allowed to earn- pressing a larger percentage of the total money into services.  

We’re also making real efforts to bring members, families, advocates and stakeholders together as a community to work with a common purpose to preserve and strengthen the behavioral health system.  Members and families routinely sit on our committees and offer valuable input in the redesign of programs that have to operate with less funds. Member-operated organizations such as the Phoenix Visions of Hope have created programs such as warm line crisis response to help members who have lost benefits and need help.  The Family Involvement Center, which offers support to family members in the behavioral health system, has a number of programs to help family members cope with the loss of benefits. 

We’ve also been encouraging the integration of physical and behavioral healthcare among behavioral health providers with acute care health plans and community health centers around the state.  Our new reform initiative will offer whole heath services to persons with Serious Mental Illness in Maricopa County beginning in October 2013.  Tragically, folks with serious mental illness typically die 25 to 30 years younger than the general population, primarily because of physical health issues, many of which are preventable.  This initiative, through the development of Health Homes, will offer these individuals both physical and behavioral health care through one health plan by a team of dedicated health care professionals.  Not only will this new health care delivery system improve health outcomes and reduce costs, there will be an emphasis on prevention, wellness and self-directed disease management programs that have typically not been offered as a routine part of health care.  While these partnerships should also reduce overall healthcare costs, they will also improve quality of care and health outcomes. 

There’s no question that these are tough times and our hearts go out to those who are suffering.  However, we’ll continue to do everything in our power to minimize any harm brought on by budget cuts and continue to make the adjustments in a way that maintains stability and keeps our system strong.  You have my commitment that every decision will be made with our members’ best interest as the number one priority.  Our primary goal—even during these challenging budgetary times—is to provide the best possible behavioral health care to our members and we’re committed to achieving that goal along with our partners in the behavioral health system- and to seek out new ways (like integrating behavioral primary health care) to improve health and wellness.