Arnold v. Sarn Blythe Fitzharris, Mercy Maricopa Kelli Donley, Az Department of Health

Arnold v. Sarn history A class action suit—Arnold v. Sarn—was filed in 1981 against the State of Arizona on behalf of those adults with a serious mental illness in Maricopa County. In January 2014, an exit agreement was signed with specific stipulations for fiscal years 2015 and 2016.

Three methods of evaluation SAMHSA fidelity review of providers ADHS contracts with Western Institute of Higher Education (WICHE) Four reviewers hired Provider calendar created with MMIC Quality service review ADHS contracts with Intergrowth Network analysis ADHS contracts with Mercer

Service capacity increases Assertive Community Treatment teams: 8 Permanent supportive housing: 1,200 Supported employment: 750 Peer and family services: 1500

Arnold v. Sarn Goals for FY 15 1. Fully implement SAMHSA evidence-based practices related to Assertive Community Treatment (ACT), consumer-operated services, permanent supportive housing (PSH), and supported employment (SE) 2. Transform the service delivery system to promote and incentivize high-quality care 3. Increase the network’s capacity to deliver ACT services by 4 teams 4. Increase network capacity to provide supported employment services by 375 5. Increase permanency by expanding permanent supportive housing capacity by 425 6. Improve the accessibility of peer and family support services by expanding capacity by 700

Accomplishments Expansion Assertive Community Treatment – GOAL: 4 Teams August 2014, Forensic ACT team with CBI November 2014, ACT team with SWN, Saguaro site February 2015, Medical ACT team with PIR, Arrowhead May 2015, ACT team with Circle the City Capacity for original 15 teams currently at 3% vacancy and tracking enrollment for new teams 2. Supported Employment – GOAL: 375 SE providers onsite at adult SMI clinics Expanded capacity to serve up additional 425 members To date, 505 unduplicated members have received SE since July 2014

Accomplishments Expansion Permanent Supportive Housing –GOAL: 425 rental subsidies October 2015, expanded contract capacity for: 500 rental subsidies connected with supportive services (ABC, NAC and CPLC) 200 supportive services with CBI, SWBH, PSA, AHCCCMS and MARC 500 members have received housing vouchers 403 members have been housed 4. Peer and Family Services – GOAL: 700 Expanded capacity to serve additional 900 members Program expansion includes: information and referral center, mental health court transition program, inpatient peer transition program, transitional youth transition program, WRAP, wellness programs, family psychoeducational program

Accomplishments Implement SAMHSA evidence-based practices Collaborate with ADHS/DBHS and Western Institute of Higher Education (WICHE) in the completion for reviews and provider fidelity review calls Provided direct TA to educate, complete readiness reviews and address fidelity review findings Hosted conference in collaboration with WICHE to address fidelity review trend findings and provide education on the implementation of EBPs Evaluating system transformation opportunities to align practices with EBPs and planning for FY16

Accomplishments Transform the service delivery system to promote and incentivize high-quality care Implemented incentive-based contracts with a focus on clinical outcomes for All expanded ACT teams All expanded PSH service and housing providers

Moving toward FY16 Expand capacity to meet settlement agreement in FY15 and FY16: Supported housing services capable of serving 1,200 members Supported employment services capable of serving 750 8 ACT teams Family and peers service capable of serving 1,500 Expand opportunities to implement and shift system transformation with payment reform Monitor and track compliance with fidelity standards for all identified providers and utilization of expanded services

Questions? Kelli Donley Kelli.donley@azdhs.gov 602-364-4651