A Recent History and Olmstead Activities
- Arnold v. Sarn Stipulation: As part of the Arnold v. Sarn Stipulation for Providing Community Services and for Terminating the Litigation, signed in January 2014, the Arizona Department of Health Services/Division of Behavioral Health Services (ADHS) and the State of Arizona agreed to provide certain community services and terminate the litigation. The agreement included an increase of services in four areas: Assertive Community Treatment, Supported Employment, Supportive Housing and Peer and Family Services. Each of these areas had target goals to expand service capacity and all goals were met by July 2017.
- Autism Spectrum Disorder (ASD) Advisory Committee: The Autism Spectrum Disorder (ASD) Advisory Committee was appointed in Spring 2015 and charged with articulating a series of recommendations to the State for strengthening the health care system’s ability to respond to the needs of AHCCCS members with or at risk for ASD, including those with comorbid diagnoses. The charge included focusing on tasks related to more access to services for members and assisting members in becoming more independent in the community.
- Foster Care Community Liaison: Stemming from the 2016 Arizona House Bill 2442 (Jacob’s Law), AHCCCS created a new position titled Foster Care Community Liaison within the Office of Individual and Family Affairs, whose purpose is to collect and share the voice of youth involved with the Department of Child Safety (DCS) at all levels of the Medicaid system.
- Administrative Simplification: On July 1, 2016, the Arizona Department of Health Services, Division of Behavioral Health Services (DBHS) merged with AHCCCS in an effort to streamline monitoring and oversight of the Regional Behavioral Health Authorities throughout Arizona. DBHS and AHCCCS had historically been partnered working to improve care for Arizonans receiving behavioral health services. Governor Ducey recommended formalizing the partnership by bringing DBHS and AHCCCS together. The administrative simplification did not change services members can receive, nor did it change how members receive services.
- Housing: In 2016, AHCCCS became responsible for the management and oversight of AHCCCS housing and services for persons with an Serious Mental Illness designation under administration simplification. If AHCCCS were a housing authority, it would be the third largest in the state of Arizona with an annual budget of $27.7 million in non-Medicaid, state-only funds to provide rent subsidies for almost 3,000 AHCCCS members with an SMI designation, and for a small number of high-need individuals in need of behavioral health and/or substance use treatment. AHCCCS also administers the State SMI Housing Trust Fund (SMI HTF) to which approximately $2 million of state funds are appropriated per year, to expand housing capacity for persons with an SMI designation. Since 2017, SMI HTF money has been invested to construct or acquire 246 new affordable housing units for AHCCCS members with an SMI designation. AHCCCS also collaborates with local housing authorities, tax credit programs, and the HUD Continuum of Care (HUD CoC) program to provide PSH capacity for an additional 1,500 members.
- Targeted Investment (TI) Program: In 2017, AHCCCS initiated the Targeted Investments (TI) Program, which is a strategy to provide financial incentives to eligible AHCCCS providers who meet certain benchmarks for integrating and coordinating physical and behavioral health care for Medicaid beneficiaries. The TI Program incentivizes prescribed care coordination processes for different participating groups, such as TIP justice clinics (e.g., required Forensic Peer and Family Support Training); adult healthcare providers (e.g., screening all members for social risk factors and behavioral health disorders); and pediatric healthcare providers (e.g., requirement to identify community-based resources and referral procedures for members).
- Behavioral Health Expansion in Schools: While schools have historically been approved settings for Medicaid-covered behavioral health services, in 2018 $3 million in state General Fund dollars were appropriated to expand behavioral health services in schools; $1 million of this funding is being used in a partnership with the Arizona Department of Education to provide mental health training to schools and school districts.
- Project AWARE: A five-year SAMHSA grant that began in 2018 in an effort to address Arizona’s challenges to individual, family, and community mental health and wellness in schools, Arizona Project AWARE planned and implemented strategies and activities to build and maintain infrastructure for mental health services in Arizona schools for school-age children; conduct outreach and engagement with school-aged youth and their families to increase mental health awareness; and provide professional development and training.
- Integrated Care: On October 1, 2018, AHCCCS established a new integrated system called AHCCCS Complete Care (ACC) that joined physical and behavioral health services together to treat all aspects of our members’ health care needs under a single, chosen health plan.
- COVID-related Flexibilities: Beginning in March, 2020, AHCCCS, through CMS-approved flexibilities, implemented a number of changes in response to the COVID-19 Public Health Emergency to ensure ongoing access to care.