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In This Issue


Board of Directors 
Michael Shafer, Ph.D. Chair  
Joshua Mozell, J.D., Vice Chair  
Kristina Sabetta, MSW, APSW, Secretary  
Jason Bernstein, C.P.A., Treasurer

Jack Beveridge
Max Dine, M.D.

Sheri George
Charles Goldstein, M.D
Laurie Goldstein

Emily Jenkins, J.D.
Marcus Johnson, MPH
Barbara Lang, M.A., L.P.C., LISAC, CCSOTS

Karen Pitico, M.P.H.
Mohamed Ramadan, M.D. 
Clarke Romans
Coming Events

Regional Behavioral Health Authority Calendars: 
Cenpatico Community Events
Mercy Maricopa Community Events 
Health Choice Integrated Care Community Events 
AZ Center for Applied Behavioral Health, Upcoming 

Arizona Trauma Institute Trainings 
Family Involvement Center Calendar

NAMI AZ Calendar 
Mental Health First Aid trainings
Pima County,Or Contact at Steve Nagle,

Maricopa County Or Contact Lyle Mazer at

Northern Arizona: Kelli Behrends
Arizona Coalition for Military Families

February15, 2016
MHA-AZ's Annual SEEDS Conference
May 20-21, 2016
Conference Theme: B4Stage4: Starting the Conversation

Keynote Speaker:   Paul Gionfriddo  President & CEO of Mental Health America, and author of the critically acclaimed book, Losing Tim:   How Our American Educational and Health Systems Failed My Son with Schizophrenia.

Who Should Attend?   Parents, siblings, spouses of people living with a mental illness, people with the lived experience of mental illness, school teachers and counselors, clergy and members of faith communities, mental health professionals.  

2 days with more than 20 sessions, providing hands-on, practical information specifically for people with lived experience and family members.  Among the practical information to be presented will be:
* The Ins & Outs of Involuntary Hospitalization
* Psychiatric Advanced Directives
* Mental Health First Aid
* Mental Health Transition Services
* Social Security Work Incentives
* Ensuring Your Health Plan is Providing Parity in Mental Health Services
* Working with Your Primary Care Physician to Maximize Coordination with your Mental Health Provider
* The Essentials  of Establishing a Special Needs Trust for your Child

Costs: $59 two day, $39 one day for family members and people with lived experience; mental health & social service professionals $109 two days; $79 one day.   (10 CEUs)

Location: Arizona State University Downtown Campus, Central & Filmore

For more information visit MHA-AZ's website or you may register  here.

Will Session Adjourn by Easter? 

Legislative session is humming along at "breakneck" speed.  The final bill filing deadline in the House was February 8th.  At this pace, we'll see over 1,200 bills introduced, together with over 100 memorials or referendums.   Ultimately, 250 to 300 bills will be enacted.  These numbers, however, don't include the 10 to 15 bills that will be introduced when the budget for FY 2015-16 is considered and enacted.  That puts lots of pressure on legislators to be fully briefed and ready to make decisions on a plethora of topics.

Hot public policy debates have erupted on three fronts.  First, in response to concern about the financial viability of the public safety retirement system, an agreement has been forged after significant negotiations and support of most of the public safety labor unions in the state.  The bill to address this is poised to move forward.  The second contentious topic has been funding for JTEDs (joint technical education districts).  Funding was cut by $30 M last year, with the Governor proposing in his budget an increase of $10 M per year over the next three years.  In response to concerns raised by JTED districts,  the legislature appears ready to provide $28 M this year.  The third topic is the ongoing crisis around the Department of Child Safety, with 19,000 children in out-of-home placement and a high turnover rate among the CPS staff.  A variety of bills have been proposed to address these issues, but no silver bullets have been identified.  

Here is what the Governor's budget includes:


For AHCCCS, the budget supports the move of the DHS' Behavioral Health division to AHCCCS with funding for these services at $517.3 M (General Fund, or GF); it also allocates $30.8 M in GF for caseload growth for acute, ALTCS and behavioral health and  restores preventative dental for ALTCS members $1.4 M (GF).


DES recommended funding seeks $29.7 M to support caseload increases for DDD ALTCS; $2.9 M (GF) to handle the growing number of calls for Adult Protective Services; adds $6.4 M (GF) to increase rates for child care subsidies; adds $5.18 M (GF) to serve 4,900 individuals on the waiting list for Vocational Rehabilitation services; $1.2 M of GF to cover adult dental services for DDD clients; $2.4 M  (GF) to overcome structural deficits in residential room & board for DDD clients; and a GF saving of $856,200 by eliminating fingerprint requirement for TANF & SNAP applicants.


DHS recommended funding revolves around assuring there are sufficient staff to meet licensure standards at ASH including $1.5 M (GF) for 14 Nurses & 15 Security Personnel; $1.2 M (GF) for medication for ASH patients; and $400,000 to cover Newborn Screening Program Funding.


The DCS total request includes $64.0 M (GF) for support services & staff for out-of-home support services, case aides, and permanency planning; and  an additional $9.0 M (GF) to the Attorney General and Judiciary to handle the backlogs in the court with handling CPS cases.


Issues that didn't get included in the Governor's budget were 1) restoring the KidsCare program; 2) restoration of the 24 month time limit for TANF; 3) no new funding for home & community based services for older adults, homeless, domestic violence and food banks; 4) no funding provided for the medical student loan repayment program; and 5) no new funding above the base of $11 M for Healthy Families.  

The challenge is to see how the legislature responds to the Governor's proposed budget and how quickly this essential legislative business is completed.  Once the budget is adopted there's usually a rush to leave.  This is an election year, so the desire to hit the campaign trail is ever present.  

MHA-AZ has 75 bills on a "watch list", with topics ranging from the regulation of sober living homes to restoring the KidsCare program to allowing DOC to establish a mental health pilot transition program for up to 600 inmates in the first year to changes affecting incompetent defendants, which Jim McDougall describes in the article below.    

As Mark Twain said, "No man's life, liberty, or property are safe while the legislature is in session."  We will keep monitoring the legislature's activities and the actions that impact our mental health community. 
Revolving Door

Most of us are aware of the frustrating "revolving door" problem in our mental health treatment system, but there is another revolving door problem equally as frustrating that brings the criminal justice system into conflict with the civil commitment system. In the criminal justice system, a person cannot be tried for a criminal offense if they are found to be incompetent to stand trial. "Incompetent to stand trial" means that the person is not capable of understanding the trial process and cannot assist his attorney in his own defense.  Defendants who are found incompetent to stand trial are usually ordered to undergo a period of rehabilitative treatment to restore their competence to stand trial for up to a period of 21 months. If the defendant's competence to stand trial cannot be restored, the criminal court enters a finding that the defendant is incompetent and not restorable, at which time the criminal court has some limited options, none of which the criminal justice community is completely comfortable with - the court can remand the defendant to the custody of DHS for institution of civil commitment proceedings, appoint a guardian for the defendant under title 14 or release the defendant and dismiss the charges against the defendant without prejudice, meaning that the charges can be refiled again at a later time. Some of the defendants found incompetent to stand trial have been accused of committing violent crimes sometimes resulting in death or serious harm to their victims, and some of these defendants have been in the criminal justice system before and found incompetent to stand trial. The route most often chosen by the criminal justice system for these defendants is a referral to the civil system for commitment in an effort to find a secure placement for the individual where the public's safety can be protected. However, because the defendant has often received mental health treatment during the process to restore competence and because the act upon which the Petition for Court Ordered treatment occurred, in many cases, over a year before, the defendant is either found not to qualify for civil commitment and is released or is treated very briefly and then released from inpatient treatment and is placed back into the community, where sometimes the patient stops treatment, decompensates, commits another violent crime, is arrested, and the whole process starts over again.  

For the past several years a bill sponsored by Arizona prosecutors has been filed with the Arizona Legislature attempting create a "system" for "Dangerous Incompetents". Past efforts have all failed for lack of a funding source to cover such a system. That effort this year is contained in SB1412. This bill provides that if an incompetent defendant is also found by the criminal court to be dangerous he can be placed in a secure setting until he is found competent to stand trial or not dangerous. The bill also provides amendments to the involuntary treatment system under Title 36 that would require strict notice requirements to prosecutors for defendants referred to the civil system for civil commitment who do not get evaluated, do not qualify for court ordered treatment, or who do not follow a treatment plan or are discharged from treatment, so that they can be pulled back into the criminal justice system for refiling of charges, further efforts to regain competence or other options available to the prosecutors.

By Jim McDougall, Attorney with Frazer, Ryan, Goldberg & Arnold, LLP.   

Mental Health America of Arizona wants to acknowledge the support of Janssen Pharmeutical Company for our activities.  Corporate support is key to assuring there's a voice in the community. 

We invite your participation and sharing of this newsletter by forwarding to your friends and colleagues.  If they wish to receive the newsletter, encourage them to simply click on the link here.  Let's share the word.  Time to get involved.
Eddie L. Sissons
Executive Consultant
Mental Health America of Arizona | | |