Arizona moving forward to address troubled MH system.

Following a court-ordered audit which revealed deficiencies in Arizona's public mental health system, state officials have begun implementing changes, including hiring additional case management staff and renovating some of Maricopa County's most troubled clinics, in compliance with a court mandate to address the problems by Dec. 17.

The Superior Court of Arizona, Office of the Monitor, in its 2004 Independent Review, revealed that 85 percent of people with a serious mental illness in Maricopa County do not receive needed services. The audit, released in August, points to poor clinical outcomes, a lack of peer support services and employment services, ineffective treatment plans and poor case management.

Periodic audits of the state's public mental health system stem from a class action lawsuit, Arnold v. Sarn, filed in 1981 on behalf of all persons with serious mental illness (SMI) in Maricopa County. The lawsuit challenged state and county officials' failure to provide appropriate community mental health services for all members of the plaintiff class. There are approximately 17,300 persons with serious mental illness in Maricopa County, say officials.

The Arizona Department of Health Services/Division of Behavioral Health Services (ADHS/DBHS) provides for public behavioral healthcare through a mechanism of private Regional Behavioral Health Authorities (RBHAs).

ValueOptions has served Maricopa County's RBHAs over the last four years. The organization manages the behavioral health services for Medicaid-eligible residents of Maricopa Country, which includes Phoenix and about 80 percent of the state's population. The organization earlier this year was awarded a three-year full-risk contract, ValueOptions' largest public sector contract (see MHW, Feb. 16).

"Our staff looked at the audit as a quality improvement activity," Michael Zent, Ph.D., chief executive of ValueOptions of Arizona, told MHW. "We see it as a real opportunity to improve the system. It has galvanized people, the state, the advocacy community, families, and our own …