988 Implementation Planning
AHCCCS is working with state and federal partners to launch 988, the national number that will replace the National Suicide Prevention Lifeline (NSPL) in July 2022. Much like America uses 911 for emergencies, 988 will be the national 3-digit phone number for mental health crises.
To support 988 implementation planning, AHCCCS and its contractor, LeCroy & Milligan Associates, collected stakeholder input to identify opportunities to continue to improve Arizona’s crisis system. In 2021, AHCCCS facilitated more than 10 stakeholder meetings and focus groups with people who have lived experience with behavioral health crises, and conducted a survey of those with lived experience who have engaged with the crisis system. The survey received responses from 589 people in Arizona, including 180 individuals who had engaged with the crisis system for themselves, and 391 individuals who had engaged with the crisis system for someone else. A summary of survey results was presented to stakeholders in December 2021 and relevant survey results have been integrated into this plan as they relate to the eight core areas required to be addressed in the implementation plan.Funding 988 & the Arizona Crisis System
LMA Stakeholder Feedback
LMA Crisis Line Survey Report
988 State and Territories Cooperative Agreement Grant (SAMHSA)
In order to effectively implement 988 standards within Arizona, AHCCCS applied for the 988 State and Territory Cooperative Agreement offered by Substance Abuse and Mental Health Services Administration (SAMHSA), for States and Territories to Build Local 988 Capacity. The purpose of this cooperative agreement is to improve state and territory response to 988 contacts originating in the state/territory by:
- recruiting, hiring and training behavioral health workforce to staff local 988/Lifeline centers to respond, intervene, and provide follow-up to individuals experiencing a behavioral health crisis;
- engaging Lifeline crisis centers to unify 988 response across states/territories; and
- expanding the crisis center staffing and response structure needed for the successful implementation of 988.
- ensure all calls originating in a state/territory first route to a local, regional and/or statewide Lifeline crisis call center;
- improve state/territory response rates to meet minimum key performance indicators; and
- increase state/territory capacity to meet 988 crisis contact demand.
To meet the requirements of this funding opportunity, AHCCCS must ensure that all calls originating in a state/territory first route to a local, regional and/or statewide Lifeline crisis call center, including coverage of American Indian/Alaska Native tribes in Arizona. To meet the requirements of the grant, AHCCCS has partnered with the Arizona Lifeline centers to ensure accountability of distribution of funds and performance metrics.
Per the Notice of Funding Opportunity released by SAMHSA, no less than 85 percent of grant funds must be allocated through selected local, regional, and/or statewide Lifeline crisis centers for workforce capacity and related expenditure. The current Lifeline crisis centers in Arizona are operated by Solari and La Frontera Empact.
988 State and Territories Cooperative Agreement – Supplemental Grant
The Substance Abuse and Mental Health Services Administration (SAMHSA) has awarded Arizona the 988 State and Territory Cooperative Agreement one-year supplemental funding of $1,000,000.00.The purpose of this supplemental funding is to expand and enhance 988 Suicide and Crisis Lifeline activities in Arizona.
With these funds, AHCCCS and the Arizona Lifeline centers will focus on the following activities:
- Enhance 988 and 911 coordination in collaboration with the state or territory’s 911 administrator.
- Improve state infrastructure and workforce to prepare for 988 Lifeline chat and text services initiated within the state or territory and in-state backup for calls, chats, and texts.
- Develop partnerships across the state to create streamlined access to mobile crisis and crisis response teams for all 988 crisis centers.
- Develop state capacity to increase service to Arizona’s higher-than-average Spanish speaking population.
- Develop and enhance technical systems and solutions to better support individuals throughout the crisis care continuum, including modification to EHR/EMR/online documentation management systems to ensure continuity of care and referral.
AHCCCS 988 Advisory Committee
AHCCCS has established a 988 Advisory Committee to help monitor and guide the 988 implementation plan and ensure that the Arizona Crisis System is prepared to meet the needs of all Arizonans who contact the Lifeline.
The Advisory Committee is tasked with:
- Monitoring the progress of AHCCCS' 988 implementation goals and objectives,
- Reviewing data on increased crisis service contacts and outcomes,
- Developing recommendations for course correction and goal revision, as needed, and
- Providing ongoing updates on how 988 implementation is impacting our communities.
AHCCCS is committed to ensuring that the Advisory Committee represents our communities and includes participation from crisis service providers, contracted health plans, 911 Administration, State and Tribal partners, community advocates, and individuals who have lived experience navigating public behavioral health services.
Cooperative Agreements for States and Territories to Improve Local 988 Capacity
Arizona has been awarded a Cooperative Agreement for States and Territories to Improve Local 988 Capacity by The Substance Abuse and Mental Health Services Administration (SAMHSA). This is a three-year project with the purpose of improving states and territories’ response to 988 contacts (including calls, chats, and texts) originating in the state/territory.
These funds will be used by Arizona to address the urgent need to strengthen crisis response and support systems in the state for 988-generated contacts. With a focus on reducing suicide rates and improving mental health outcomes, our interventions aim to enhance access to timely and effective care for individuals experiencing mental health emergencies. The project will focus on three key strategies:
- Lifeline Expansion and Enhancement: We will expand the capacity and accessibility of the state's suicide prevention helpline, ensuring that individuals in crisis have immediate access to trained professionals and resources. By increasing the helpline's coverage and availability, we aim to reduce the barriers to seeking help and provide critical support to those in need.
- Community Education and Awareness: Through targeted education campaigns, workshops, and training programs, we will raise awareness about suicide prevention, mental health, and the available support services. By empowering communities with knowledge and resources, we seek to reduce stigma, promote early intervention, and encourage help-seeking behavior among at-risk populations.
- Strengthening Post-988 Supports: We will strengthen partnerships among mental health providers, crisis centers, community organizations, and other stakeholders. These collaborations will facilitate a coordinated response to mental health emergencies, ensuring seamless transitions of care and comprehensive support for individuals in crisis.
Additional ResourcesADOA/911 Administration 988 Information Page
988 Suicide and Crisis Lifeline (SAMHSA)
988 Lifeline Performance Metrics