“Reaching across Arizona to provide comprehensive quality health care for those in need” Super Utilizer Strategies- Correctional Partners Michal Rudnick AHCCCS Update Meeting January 15, 2014 Our first care is your health care Arizona Health Care Cost Containment System 1

“Reaching across Arizona to provide comprehensive quality health care for those in need” Our first care is your health care Arizona Health Care Cost Containment System 2 Mental Health & Corrections 

“Reaching across Arizona to provide comprehensive quality health care for those in need” Our first care is your health care Arizona Health Care Cost Containment System 3 Statistics - ADOC  ADOC houses over 40,000 detainees in 15 different facilities  In FY13, DOC admitted 18,677 and released 17,868  In FY13, the total annual cost per inmate was $23,865.36

“Reaching across Arizona to provide comprehensive quality health care for those in need” ADOC Health Services  ADOC spends an estimated $140 to $150 million on health expenses each year  60%-70% for mental health/substance abuse treatment In FY13 DOC treated a total of:  10,008 inmates for ongoing mental health services  2,498 detainees for substance abuse treatment  210 detainees with HIV  6,094 detainees with Hep C  156 detainees with hospital admissions  0 detainees with active TB Our first care is your health care Arizona Health Care Cost Containment System 4

“Reaching across Arizona to provide comprehensive quality health care for those in need” Our first care is your health care Arizona Health Care Cost Containment System 5 Statistics - County  County Jails release over 100,000 detainees annually  Counties collectively spend an estimate of $90 million on health services annually  60% - 70% for behavioral health services  FY13 - Maricopa County Jail spent: $53,547,105 on health services $6,701,884 of that on inpatient mental health services $30,132,650 was spent on outpatient treatment and evaluation

“Reaching across Arizona to provide comprehensive quality health care for those in need” What Does AHCCCS Spend?  In FY11, AHCCCS spent over $187,000,000 on members who were incarcerated at some point before or after enrollment  Of the over $187,000,000 spent, the highest costs included conditions related to mental health and substance abuse Our first care is your health care Arizona Health Care Cost Containment System 6

“Reaching across Arizona to provide comprehensive quality health care for those in need” Current Eligibility  Department of Corrections When enrollment is identified, eligibility is terminated Process pre-release applications for detainees with special healthcare needs  Counties Currently 6 counties have an enrollment suspense/reinstate process (including Maricopa and Pima) Our first care is your health care Arizona Health Care Cost Containment System 7

“Reaching across Arizona to provide comprehensive quality health care for those in need” Future Eligibility Opportunities  Implement an enrollment/suspense process for short-term DOC detainees  Improve the application process for Jails/DOC in HEAplus  Volunteer efforts Our first care is your health care Arizona Health Care Cost Containment System 8

“Reaching across Arizona to provide comprehensive quality health care for those in need” Care Coordination & Strategies to Deal With High Risk  Today, T/RBHAs & behavioral health providers are expected to collaborate & coordinate care  Future opportunities could include engaging those at high risk during probation to coordinate services  Michigan efforts focused on care coordination prove successful  Collaborate with stakeholders (Plans, DHS, RBHAs) to develop a more robust process for coordination of general medical and behavioral health services Our first care is your health care Arizona Health Care Cost Containment System 9

“Reaching across Arizona to provide comprehensive quality health care for those in need” Questions/Comments? Our first care is your health care Arizona Health Care Cost Containment System 10