Arizona has evolved its crisis response system over the past 15 years, establishing a model that emphasizes coordination, accessibility, and fiscal responsibility. At the heart of this transformation is a managed Medicaid structure, a robust funding strategy, and a commitment to treating individuals in the community.

Arizona's Managed Medicaid Structure

The foundation of Arizona's crisis system lies in its managed Medicaid structure which is overseen by a central authority. In this case, the Arizona Health Care Cost Containment System (AHCCCS) plays a pivotal role. AHCCCS consolidates funds from diverse sources, including Medicaid funds, SAMHSA federal block grants, and state/local funds, allowing the state to leverage funding effectively. It ensures access to an array of crisis services, regardless of insurer.

The Regional Behavioral Health Authority (RBHA) serves as an accountable entity in the crisis system. This structure facilitates coordination with various providers, creating a symphony of services aligned toward common clinical goals. Dr. Margie Balfour, chief clinical quality and innovation officer at Connections Health Solutions, often refers to the RBHA as the "symphony's” conductor and guiding force ensuring all components work together seamlessly.

Fiscal Responsibility and Clinical Objectives

Arizona's crisis system strategically intertwines clinical objectives with fiscal responsibility. Margie Balfour articulated the financial benefits of crisis services, highlighting that it makes both clinical and fiscal sense. Dr. Balfour shared, “Hospitals are expensive, and emergency rooms are expensive, and jails are expensive. So crisis is a really great thing, because you can get both people on board who want to do this because it's clinically the right thing, morally the right thing, but it's also the fiscally responsible thing to do, especially since a lot of these services are publicly funded.” By keeping individuals within the community and treating them in the safest and least restrictive setting, the system achieves not only better clinical outcomes but also significant cost savings by minimizing the use of expensive alternatives.

Arizona's crisis system stands as a testament to innovation in mental health intervention. The state's managed Medicaid structure, diverse funding sources, and the REBA's role as the conductor of crisis services, contribute to the effectiveness of the crisis response. By aligning services toward common clinical goals and emphasizing community-based treatment, Arizona has created a harmonious and fiscally responsible model for crisis intervention that other states may find inspiring as they navigate the complex landscape of mental health services.

Source: National Advancements in Crisis Services: Defining and Refining Responder Roles