HEALTH, WELLNESS AND LONGEVITY INITIATIVE Magellan Health Services of Arizona Clinical Initiatives

Magellan Health Services of Arizona HEALTH, WELLNESS AND LONGEVITY INITIATIVE Magellan Health Services of Arizona is working to transform the behavioral health care system in Maricopa County by focusing on FIVE key initiatives: Robert Sack, MD2 Outcomes - Measures efforts to strengthen the behavioral health system through online dashboard that monitors 18 core metrics of quality and performance. Suicide Prevention and Intervention - Provides clinical care workers and case managers with the skills, training and resources they need to talk openly and directly about suicide. Crisis Planning - Will support the development of proactive crisis plans for service recipients to assist them before a crisis situation happens; prepare staff to provide effective reactive crisis response 24 hours per day, seven days per week, and ensure they follow up after a crisis episode. Clinical Care - Will help move the system to a model of clinical care management focused on creating therapeutic opportunities for service recipients and away from a broker model of case coordination focused on recipient referrals. Health, Wellness and Longevity is what I’m here to talk about today…

Robert Sack, MD3 Magellan Health Services of Arizona HEALTH, WELLNESS AND LONGEVITY INITIATIVE Based on a report published by the National Association of State Mental Health Program Directors, USA Today published in 2007 that adults with serious mental illness (SMI) treated in public systems die approximately 25 years earlier than Americans overall. In Maricopa County, the largest and most populated county in Arizona, the rate of premature death for persons with SMI is 31.8 years earlier than that of the general population. Also, the SMI population also has a higher rate of diabetes, hypertension, obesity and dyslipidemia than the general population, and the incidence of cardiovascular disease in persons with SMI is two to three times that of the general population. Persons with SMI diagnoses also have poorer diets and are more sedentary than the general population.

Robert Sack, MD4 Magellan Health Services of Arizona HEALTH, WELLNESS AND LONGEVITY INITIATIVE Transformation Transition Initiative (TTI) Grant In partnership with the Arizona Department Health Services, Division of Behavioral Health Services (DBHS), Magellan of Arizona was awarded a TTI Grant—one of only 3 in the nation– to train and implement a peer delivered Whole Health program. All four Provider Network Organizations (PNOs) are participating in the initiative, and each has submitted their own implementation plan; these four PNOs treat our SMI population. Thus far, 72 peer and family mentors, PNO staff, DBHS staff and Magellan staff have been trained in the Peer Engagement of Whole Health process, and 250 services recipients are participating. A wellness journal and data collection sheet—utilized by the recipients with peer oversight—track six measurable outcomes: Weight, Body Mass Index, Blood Pressure, Reduced Smoking, Improved Sleep, Increased Exercise.

Robert Sack, MD5 Magellan Health Services of Arizona HEALTH, WELLNESS AND LONGEVITY INITIATIVE Tobacco Cessation Program According to studies published in the Journal of the American Medical Association and the Journal of Dual Diagnosis, people experiencing a serious mental illness are twice as likely to smoke as other persons. It is estimated that in Arizona, 70 percent of individuals with serious mental illness and 35 percent of behavioral health staff currently smoke. In partnership with Arizona Smoker’s Help Line (ASHLine), the Centers for Disease Control, the Arizona Department Health Services/Division of Behavioral Health Services, we are participating in an $820,000 ARRA grant funded, two-year tobacco cessation program for service recipients—and staff—at the clinic level. The initiative will focus on improving access to the ASHLine tobacco “quit line” by SMI clients and increasing the number of SMI clients who utilize “quit line” services. The ultimate goal is to increase the total number of clients with SMI who quit. The long-term plan is to take the program statewide.

Robert Sack, MD6 Magellan Health Services of Arizona HEALTH, WELLNESS AND LONGEVITY INITIATIVE Other efforts supporting our Health, Wellness and Longevity Initiative Magellan of Arizona recently implemented a fully integrated Electronic Health Medical Record (EHMR) that is used by the four Provider Network Organizations that serve adults with SMI, with the following: o Integrates key health issues like tracking and trending Body Mass Index (BMI) Blood Pressures and documentation of "life-style assessment and education" about smoking, dietary patterns, sleep and exercise o Side-by-side listing of behavioral health and primary care medications In FY2011, Magellan of Arizona will introduce a Balanced Scorecard dashboard for staff effectiveness/productivity at the adult Provider Network Organization clinics, which embeds recipient feedback collected through the Consumer Health Inventory (CHI) Additional funding for Maricopa County Consumer Support Agencies (CSAs) for health and wellness promotion and activities, prompted by the North Phoenix Visions of Hope program for individuals with SMI and diabetes, staffed by an out- stationed specialty nurse.

Questions? Robert Sack, MD7