Arizona System of Care
The purpose of this section is to provide current information, activities, and updates related to the AHCCCS System of Care.
The Arizona System of Care was initially developed as a set of Values and Principles to guide behavioral health service delivery to children in Arizona. These Values and Principles were established under the Arizona Vision established by the Jason K. Settlement Agreement in 2001. The goal of the System of Care has been, and continues to be, to ensure provision of services designed to aid children to achieve success in school, live with their families, avoid delinquency, and become stable and productive adults.
Since July 1, 2016 when the Arizona Department of Health Services, Division of Behavioral Health was incorporated into AHCCCS through Administration Simplification, AHCCCS has been expanding efforts to further the System of Care model to include the adult population, and to incorporate an integrated health perspective.
System Oversight Structure
- System of Care Structure, Values and Principles – AMPM 100
- Table of AHCCCS Covered Services - AMPM 300
- Title XIX XXI Behavioral Health Service Benefit - AMPM 310-B
- Services With Special Circumstances – AMPM 320
- AMPM 320-O Behavioral Health Assessments and Treatment Service Planning
- AMPM 320-P Serious Mental Illness Eligibility Determination
- AMPM 320-R Special Assistance for Members with Serious Mental Illness
- AMPM 320-S Behavior Analysis Services
- Coordination of Care with Other Government Agencies – AMPM 541
- Behavioral Health Referral and Intake Process – AMPM 580
- Behavioral Health Services for Children in Department of Child Safety (DCS) Custody and Adopted Children – ACOM 449
- Child and Family Team Practice
Since the adoption of CFT, numerous changes have occurred to the children’s system of care. These changes, plus a drift in CFT practice away from its original vision and philosophy, prompted the leaders of the AHCCCS children's system of care to conduct an evaluation of the overall CFT program. In 2019, the children’s system of care leadership team requested assistance from the AHCCCS’ Office of Healthcare Workforce Development (WFD) in reviewing the statewide curriculum and approach used to develop CFT Facilitators.
In partnership with AHCCCS’ MCOs, WFD has identified the following goals for improving current CFT training:
- By 2021, update and revitalize the CFT curriculum content and approach to include these specifications:
- A single, statewide, in person, experiential approach,
- A focused on the competencies required to perform the 9 CFT activities,
- Alignment with the CFT Practice Protocol and Supervisory Tool, to include a mix of critical clinical and essential procedural components of the facilitation process
- Be compatible with statewide network and provider specific enhancements specified by quality management, and
- Create a tiered experiential training program to include:
- Expert level training program for CFT Supervisors, Trainers, & Coaches
- Create and/or identify advanced courses in CFT to CFT Facilitator development and link them to the ongoing skill development of CFT Facilitators,
- Create an optional 2 hour orientation level program for families and children who will be participating in the CFT process,
- Create an optional 4 hour training program to enable any community member to participate in the CFT process.
Development of the CFT Facilitator training program innovations is scheduled to continue throughout 2021. At this time the development group has completed the majority of the work to revitalize and standardize the curriculum. The two tasks remaining are:
(1) to replace the CASII assessment training module and replace it with an updated module to reflect use of the CALOCUS, assessment and
(2) to pilot the revised training process with health plan members from the members of the health plans Office of Individual and Family Affairs, as well as interested advocates and families.
- Court Ordered Evaluation and Treatment
On September 4, 2020 the Arizona Supreme Court Committee on Mental Health and the Justice System provided a number of recommendations to improve the justice system for those with mental healthcare needs. This included a focus on developing strategies to engage and intervene prior to entry into the justice system.
One of the recommendations from the Committee was to review court rules and state statutes for changes that could result in improved processes when an individual may need mental health treatment. This included the recognition that persons with certain co-occurring neurological conditions (e.g. dementia, TBI or intellectual/developmental disabilities ) could benefit from improved system structure and guidance to avoid inappropriate or unnecessary involvement in the justice system via appropriate mental health assessment and treatment.
In response to the Committee’s recommendations, AHCCCS has created a Court Ordered Evaluation / Court Ordered Treatment (COE/COT) committee, which includes members from the Committee on Mental Health and the Justice System and additional system stakeholders (e.g. members of the Court, district attorney’s, mental health providers, state health plan members and The Office of Individual and Family Affairs) and community members.
The goal of this committee is to develop an effective and standardized statewide training on Court Ordered Evaluation and Treatment. This training will include individual county processes, resources, and user experience from the peer-member/family perspective. The training will be made available publicly when completed and will be targeted for use by a wide variety of audiences.
The goal is to have this training completed during the Spring/Summer of 2021.
- Implement CALOCUS across the entire children’s population to ensure availability of high needs case management to children with complex needs.
- Expand upon current treatment and housing continuum for adults and children
- Develop unified, responsive performance and quality monitoring tools, which reflect integrated care and practice
- Enhance and improve integrated care
- Reduce provider burden by removing duplicative deliverables and audits
- Review of SOC related policy deliverables
- Policy updates
- Oversight of Behavioral Health Clinical Chart Audit
- Development of Care/Case Management Plan
- Oversight of Mercer and WICHE Contracts for monitoring Arnold Vs. Sarn settlement terms
- Oversight of the System of Care Practice Review process
- Implement initiatives related to expanded access to behavioral health services and integrated care
- Behavioral health in schools
- Monitor the oversight of the MCOs for members on conditional release under the jurisdiction of the Psychiatric Security Review Board
- Involvement in development of workforce competencies related to the System of Care