Wednesday, February 1, 2012

Action Alert: Contact Your AZ Legislators and Tell Them You Want NTXIX SMI Services Restored!

As previously reported, the Governor is proposing restoring $39 million for non-TXIX mental health services. A major hurdle to clear in realizing this restoration is legislative approval. When asked, the Arizona Council of Human Service Providers' CEO Emily Jenkins noted that they expect "some opposition" to the restoration. They have also provided a list of talking-points to share with your legislator, and identified the following legislators which are of of particular concern (links are to their legislative pages, which includes contact information):


Cecil Ash (R-18)
Kate Brophy McGee (R-11)
Heather Carter (R-7)
Steve Court (R-18)
Karen Fann (R-1)
Doris Goodale (R-3)
Russell L. Jones (R-24)
John Kavanagh (R-8)
Nancy McLain (R-3)
Amanda A. Reeve (R-6)
Andrew M. Tobin (R-1)
Michelle Ungeti (R-8)
Vic Williams (R-26)
Kimbery Yee (R-10)


Nancy K. Barto (R-7)
Andy Biggs (R-22)
Rich Crandall (R-19)
Linda Gray (R-10)
John Nelson (R-12)
Don Shooter (R-24)

Please contact your legislator(s) (and especially the ones on this list) and ask them to approve Governor Brewer's proposed budget increase.

Arnold v. Sarn Update: December Joint Status Report

In an effort to keep people informed as to what's going on in Arnold v. Sarn, I'm providing the December "Joint Status Report" filed with the court last month.

The report is very brief and essentially states that the parties met to discuss various disagreements, and planned to meet again in January (which recently happened).

For peers (class-members) requesting information as to what was discussed at the meeting, please contact Anne Ronan. Further information is provided on this post.

Mental Health Cases Fuel: Rights vs. Safety Debate

From DC Bar, this article includes some fairly extensive coverage of Arizona, our involuntary treatment standard, as well as some historical context for similar laws across the nation.

Within the field of behavioral health advocacy, there is considerable disagreement between advocates as to the effectiveness and propriety of involuntary treatment. Particularly with regard as to whether it has led to decreases in acts of violence.

Despite this disagreement, one inescapably valid point made near the end of the article (which everyone seems to agree on) is that the debate over voluntary vs. involuntary treatment becomes almost irrelevant when there are limited services to provide in the first place. In which case, few people are able to receive services either voluntarily or involuntarily. Court-orders are either not worth the paper they're printed on, or no court-order is entered in the first place. In the case of Arizona, this has certainly been the case for non-TXIX eligible consumers over the last couple of years.

What side of the debate do you fall on, and why?

Cuts to Mental Health Programs Shift Burden to Law Enforcement

Here's a great article by psychiatrist Gary Tsai on how cuts to mental health services leads to increased encounters between people with serious mental illness and law enforcement.

A quote from the article:

Now is the time for our leaders to help safeguard the most vulnerable members of society and to seize this tremendous opportunity for improving our mental health systems. Until this happens, prisons and jails will remain the primary mental health providers in the United States.  

Read more here:

Tuesday, January 31, 2012

Can Private Psychiatric Units Assume Total Responsibility for the Most Severely Ill in Arizona?

An interesting article published in the Journal of the American Academy of Psychiatry and the Law suggests that private hospitals face an uphill battle in the ability to back-fill public psychiatric bed losses. In part, this is due to the fact that many private hospitals find it more beneficial to convert psychiatric inpatient beds into "medical-surgical beds" in order to comply with EMTALA and boost hospital operating margins.

This point raised here ties into Arnold's limitation on ASH admissions, and a potentially flawed case made for transferring almost all inpatient responsibility to private institutions.

Outside of Arnold, perhaps a more important consideration (not made in this paper, but elsewhere) is that full repeal of the "Medicaid IMD Exclusion" would increase reimbursement avenues and operating margins for all hospitals; thus ensuring that the most severely ill can receive the care they need.

Monday, January 30, 2012

On Establishing a National Legal Right to Treatment

For people with serious mental illness, there are entitlements we sunstantially enjoy here Arizona (by law), but author and family member Pete Earley makes the case why there needs to be a blanket legal right to treatment services across the nation.

From the article (emphasis added by me):

I’m not only talking about access to medications. I’m talking about requiring states to provide evidence based practices, such as excellent case management, access to assertive community treatment teams, Housing First opportunities, peer-to-peer support, transportation and other wrap-around services.

Read his full blog article here.

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