January 22, 2007

Arizona Plans Overhaul of Mental Health Care

The Associated Press reported today that state health officials have decided to revamp Maricopa County's public behavioral health system to address decades-long concerns about the way the mentally ill receive treatment.

The new plan would provide more health care choices for the 70,000 county residents who use the system. It also calls for the state to accept bids for a new provider instead of extending the contract of ValueOptions, the private firm that currently oversees the system.

The $1.4 billion, three-year contract, is the largest of its kind in the nation and has sparked intense competition. The company that lands the contract will be responsible for providing behavioral health services to low-income county residents and the seriously mentally ill, with a special focus on the homeless and those who have been in jail or in the state hospital.

ValueOptions' Dr. Don Fowls, a senior adviser to the chief executive officer, said the fact the state is seeking new bids is not an indication that ValueOptions was doing anything wrong. "I think in terms of the public sector and managing these kind of programs, (Value-Options) clearly is the national leader," he said.

Arizona is required by law to provide services for the seriously mentally ill, but a lack of resources or adequate services has long plagued the system. In 1981, advocates for the mentally ill sued the state in Arnold vs. Sarn.

The state still is subject to oversight by the court, which regularly monitors its progress in Maricopa County in serving about 18,000 adult residents with serious mental illness, such as schizophrenia or bipolar disorder.

Recently, both the state health department and ValueOptions have been criticized for a lack of oversight by a state audit and a court-appointed monitor.

A state Auditor General's Office audit also found ValueOptions paid itself at a far greater rate sometimes more than twice as much than it paid others for the same services.

ValueOptions said it had higher costs, in part, because of the Arnold lawsuit.

Under the new contract, there will be more price controls and the behavioral health authority will not operate any clinics itself. Instead, it will contract with several provider networks in hopes of infusing the system with competition and allow consumers to switch networks if they are unhappy.

Ultimately, patients would have more choice over who treats them.

Sherri Walton, vice president of the Mental Health Association of Arizona, praised the state for listening to the community in making the changes.

But the plaintiffs' attorney in the Arnold suit remains skeptical. Anne Ronan of the Arizona Center for Law in the Public Interest said she believes the state reconfigures the system too much and should instead consider longer contracts to provide stability in the system. "I think it is a mistake to assume that changing the leadership is going to solve all the quality-of-care issues that exist in the mental health system," she said.

Source: State plans overhaul of mental health care (The Arizona Republic)


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