The downward spiral: how Omaha’s criminal and mental health systems break down — and ways we could fix them

Feb 14, 2023 Connections Health Solutions

When it comes to addressing the intersections of mental health and criminal justice, it seems there aren’t many better places to work than Arizona.

Dr. Margie Balfour, chief of quality and clinical innovation at Connections Health Solutions.

“Over the years, the state has continued to invest in crisis care, because it does make good financial sense … regardless of whether you’re coming at it from social justice, clinical or as a responsible stewardship of taxpayer funds,” said Dr. Margie Balfour, chief of quality and clinical innovation at Connections Health Solutions, which runs a crisis response center in Tucson. “It’s kind of like a win-win argument in that way.”

Instead of going to crowded emergency rooms, law enforcement can bring people to the crisis response center and be out in under 10 minutes. Patients wait an average of 90 minutes to see a doctor. Staff put together patient exit plans, which can include housing, health care and social services. 

Ultimately about 85% of the 12,000 adults the facility serves annually remain stable in community-based care, according to 2019 data from Arizona Complete Health.

The work also benefits from a more streamlined funding model. After Arizona became the last state to adopt Medicaid in the 1980s, it created the Arizona Health Care Cost Containment System (AHCCCS, pronounced “access”). 

By putting health care funding through one funnel, it forces providers to work together, build stronger relationships and avoid duplicating work, Balfour said. The synergy also helps people follow through on their care plans once they’re back in the community and has led to decreases in repeat visitors to the crisis center and fewer civil commitments.