Advocacy

The Arizona Council for Human Service Providers is a membership association of agencies who provide human services to over 300,000 Arizona residents each year. Our mission is to promote and maintain a comprehensive continuum of services that help Arizona's children, adults and families build lives of quality and self-sufficiency.

We believe that the State and every community in Arizona can and should do better for vulnerable children, adults and families. We believe that improved results are possible only if we join forces in creating a common vision for the future, examine the current barriers to achieving that vision, and take bold steps to restructure our current systems. We reject any effort couched as 'reform' that simply tinkers at the edges of one agency's or Department's operations without a clear vision of where we are trying to go.

Following are selected Position papers highlighting some of our policies. Use the Quick-Jump Menu to link immediately to a chosen subject.

Advocacy Quick-Jump Menu:
2007-2008 Advocacy Agenda - Issues and Committee Recommendations
Restructuring Children's Services in Arizona
Family Builders Policy Paper
RBHA Proposal Process
Residential Care Position Paper
How YOU Can Change the Future of Arizona
Prevention Position Statement (printable, opens in a separate window)

2007 - 2008 Advocacy Agenda

Issues and AZ Council of Human Service Providers Recommendations

STATE BUDGET ISSUES
Projected $800 million to $1 billion deficit for FY’08, projected $1.7 billion deficit for FY’09

NATIONAL LEGISLATIVE ISSUES
Senate Bills 2182 & 2183 (Community Health Bills)
Rehab Option
SCHIP

ELECTRONIC HEALTH RECORDS
Encourage all state agencies to move towards the incorporation of electronic health records

WORKFORCE DEVELOPMENT
Work with elected officials to create a legislative study committee (SB1053)
Equalize pay and benefits between state and sub-contracted employees
Pursue participation in state health care plan
Licensing Reciprocity (Rep. Bradley’s Bill)
Work with other groups to create “common language and legislative objectives”

DIVERSITY
Promote the Framework and Action Plan, as well as, the Interpreter/Translation project nationally

LEGISLATIVE OUTREACH
Meetings with member agencies and their elected officials

NATIONAL REPRESENTATIVES
Facilitate strong relationships with our National Representatives and their staff

FAMILIES FIRST PROGRAM
Advocate for permanent base funding

RURAL DETOX
Advocate for permanent base funding

TEMPORARY BEHAVIORAL HEALTH LICENSE
Create a temporary facility license status

OTHER ITEMS TO MONITOR/INFLUENCE
Governors Health Care Initiative
Advocate for the creation of a state plan for meeting federal requirements of expansion of
Recovery centers and the Recovery Model
Educational Voucher Rates
Medicaid in the schools
Adolescent Substance Abuse Funding
GPS Monitors in Secure Residential Facilities
Non Title XIX Funding
Support the Healthy Arizona Initiative (Including Prevention and Wellness Programs)
Support exemptions of informed consent for school-based prevention programs
Mental Health and Addiction Parity

# # #

Click here to view/print this Agenda in PDF format.

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Restructuring Children's Services in Arizona:
Critical Issues and Sensible, Lasting Solutions

A White Paper on Improvements to the
Arizona Children's Service Delivery System

The vision for Children’s Services in Arizona
The vision for Arizona’s children services is that we will create a comprehensive, full array of services available to all children and families who reside in Arizona, provided through a privatized, integrated, community-based delivery system. Funding and administrative functions at the state level will be consolidated to better support services at the local level. We intend to build partnerships at the local level that will significantly impact, in innovative ways, the outcomes, quality, effectiveness, and efficiency of services.

Core values
The proposed children’s service system will integrate core values for children’s mental health services and child welfare “best practices.” It should be noted that these values incorporate the “J. K. Principles” that were recently adopted by a memorandum of understanding between the child serving units of state government. Those principles were the basis of settlement of the J. K. vs. Arizona lawsuit and are currently used in the service integration efforts that are under way.

• Access: Children and families will have timely access to appropriate services. Wait lists and other barriers to access will be identified and resolved.
• Individualized Services: Each child and family will receive individualized
  services in accordance with strengths and needs identified both by the client
  and through valid professional assessments. Services will be delivered in
  accordance with an individualized service plan and will be provided at the
  specific level, intensity and duration needed by the individual clients.
• Family-Centered Focus: Service planning and service provision will be designed to meet the unique strengths and needs of the child and family, and will encourage full participation of the family.
• Culturally Competent and Respectful Practice: Culturally competent services will be delivered in a manner that respects individual and family needs, cultural differences and special needs issues. Culturally competent, diverse staff will ensure that all clients receive the services they need and benefit from the services they receive and that any differences in outcomes for populations of different races, religions, ethnicity, gender, physical disability, or other characteristic are identified and addressed.
• Integration: Interagency planning, resource sharing and service delivery will be linked across current state agencies and programs and the local network of service providers. Through a shared philosophy, coordinated intake, standardized child and family strengths and needs assessments, coordinated service planning, case management systems that ensure continuity of services, the system of care will appear seamless to the individuals and families served.
• Effective and Efficient: Children, their families and the community will come to expect quality services, evidenced by improved child and family outcomes, and responsible and accountable use of public and private funds. Providers and families will be held accountable for results. Recordkeeping, data collection and reporting will be limited to federal and state funding source requirements.
• Normalized: Children will receive services within the least restrictive environment that is appropriate for their service needs and consistent with their clinical and safety needs.
• Community-Focused: Local planning, management and decision-making (backed by streamlined state administrative and funding functions) will ensure that resources meet unique community needs.
• Strengths and Results Based: Individualized treatment plans will be strength-based and goal oriented, with a solution and results focus.
• Safety Oriented: Child safety concerns can and should extend beyond the CPS system. All child-serving agencies have a role to play in ensuring safety and well-being of Arizona’s children. Crisis and safety plans will be developed for children who are returned to or remaining in their own home.
• Permanency Driven: The permanency goals of all children will be reviewed and reevaluated for appropriateness on a quarterly basis until appropriate resolution (as mandated by the Adoption and Safe Family Act) is achieved.

RECOMMENDATIONS:

• The vision developed for the Arizona system of care for children and families
  should drive decisions about that system of care.
• The Arizona Council of Human Service Providers should be represented on the Governor’s Child Protective Services Commission and the Child Protective Services Advisory Committee because we represent all aspects of the service delivery system for children and families.
• All treatment services should be accessed through and funded by a single community based system.
• The licensing functions currently housed within DES and ADHS should be combined and located within an independent administrative department.
• The focus of CPS should be the protection of children.
• The focus of the service delivery system should be on permanency and treatment utilizing the “Arizona Model” and developed and implemented from the “JK Settlement”.

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Family Builders Policy Paper

Family Builders Works!

"Family Builders came at just the right time. They have been a great help and support."

"[Family Builders] helped in every possible way from furniture to diapers to schooling for employment. We are so grateful to all of you."

"We would have to live in our car before the FB [Family Builders] program. Now we have an apartment, jobs, and our kids are safe."

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Family Builders works!

• A recent Auditor General's report leaves the impression that the Family Builders program is not effective. The reality is quite different.
• The LeCroy-Milligan Associates Family Builders Annual Program Report paints a clear and compelling picture: Family Builders works, achieves the public policy goals established, and is cost effective. The Auditor General's report itself notes the positive outcomes and impact of Family Builders in its evaluation.
• The quotes cited above and many other stories from families served by Family Builders verify one basic fact: Family Builders works. The outcome data verify this basic reality: Family Builders succeeds with families and protects children.
• The Legislature created Family Builders as a voluntary program in the private sector to achieve a 100% response rate for CPS reports. In the year prior to Family Builders, CPS responded to only about 85% of reports appropriate for investigation.
• In five years of the program, Family Builders has served over 27,000 families including approximately 64,800 children through various parts of the program. Family Builders program components include: Referral Response, Assessments, and Service Plans. Prior to the budget cuts of January 2002, Family Builders responded to almost 25% of all CPS reports.
• Family Builders does not duplicate CPS services. Family Builders serves families not served by the regular CPS program.
• For the past year, less than one percent (0.60%) of families served by Family Builders had substantiated reports six months after case closure. This clearly exceeds the goal of 5% established for the program.
• More than 38% of families referred by CPS to Family Builders receive in-home services as compared to 7% who receive in-home service in the regular CPS program. Some families referred to Family Builders decline services because they do not agree with the original CPS referral allegations, no services are needed, children are not really at risk, and other similar reasons.
• Ninety-seven percent (97%) of the Family Builders families report they were treated with respect and dignity and in a culturally sensitive manner. Family Builders is designed as a family-centered voluntary program which invites families into service rather than using the coercive power of the State to protect children. This voluntary approach clearly succeeds with families served.
• Family Builders outcome data in the LeCroy-Milligan report show families had statistically significant reduced stress in parenting, economic stress, aggressive behavior, drug and alcohol use. Reduction in stress for families prevents future abuse and neglect. Families learn how to cope with the daily grind of family life.
• Children are safer and have safe homes because of Family Builders. Abuse and neglect have been prevented. Family Builders has given new hope to families while children are being protected from neglect and harm.
• In May 2001, Family Builders received national recognition from the John F. Kennedy School of Government as an innovative program to address child abuse and neglect.

Family Builders achieves its public policy goals

• Despite being a voluntary program where families can choose to participate or not, Family Builders achieves the same outcomes as the regular non voluntary CPS program. For families which have signed Family Builders service plans, approximately 5% have had substantiated neglect or abuse reports over five years of the program.
• Most importantly, Family Builders has helped achieve one of Arizona's most important public policy goals of the Governor, the Legislature, and DES/CPS: a 100% response rate to all CPS referrals. Before Family Builders, CPS was responding to only 85% of CPS valid reports.
• For the first time in 13 years, CPS was able to respond to 100% of all valid reports because of Family Buiders. Family Builders serves families previously neglected by Arizona public policy leaving children at risk.
• Family builders assures children are protected, families are served, and CPS succeeds in its public safety responsibility. Moreover, Arizona's public policy values all children who might be at risk of neglect or abuse.
• The Family Builders program provides a positive alternative to CPS with proven and successful outcomes for families and children.

Family Builders is cost effective.

• The estimated cost savings of Family Builders is approximately $12 million per year. Family Builders cost for FY2001 was approximately $8 million. DES estimates it would cost approximately $20 million for CPS to provide the same program. Family Builders is a very cost effective way to achieve the 100% response rate to CPS reports and provide needed services to children at risk.
• After the 25% temporary reduction in rates, the approximate cost per family became $1,810. For families served with full service plans during FY2001, the cost was approximately $2,414. This compares to over $4,200 in the regular CPS program for comparable in-home services to families. Services include helping with basic needs like housing, food, transportation, homelessness, counseling, parenting, and a host of other basic and family support needs which assist the family in reducing family stressors that lead to child abuse and neglect. Another fiscal comparison is that for a home visit and an assessment the average cost to the Family Builders program is approximately $244. This compares with an estimated cost by DES of $873 for doing an investigation and connecting a family with needed services.

Impact of current budget cuts and proposed budget cuts to Family Builders

• During their special session in the fall of 2001, the Arizona Legislature reduced the Family Builders $1.8 million in General Funds. Because of this reduction, Family Builders did not serve an estimated 2,000 families including approximately 4,800 children, 20% of the projected reports of families to be referred to Family Builders. CPS was ordered to respond to these referrals without any new resources.
• As noted above, Family Builders providers also agreed to a 25% temporary reduction in rates in order to provide as much services as possible. The average rate was reduced to $1,810 per family served. At this level, providers are limited in their ability to provide needed services.
• Budget reduction proposals for 2004 eliminate all services in the Family Builders program. This move will effectively gut the program and not allow it to do what it does best - prevent further child abuse and neglect. Merely checking on a child's safety will do nothing to prevent further child abuse reports and will not insure the child's safety. All of the families visited by Family Builders would not receive services nor be helped to prevent further abuse. This will be the equivalent of your medical practitioner telling you that you have a possible fatal illness and should do something about it, with no further opportunity to address the issue.
• CPS reports are now increasing at an annual rate of 8.2%. Without additional funding, an additional 1,670 children could be at risk.
• The public policy goal of 100% CPS response is in very serious jeopardy. Without Family Builders, CPS will not be able to respond to all reports and allegations of child abuse and neglect. Arizona's public policy will return to days when all children are not protected as the 100% response to CPS reports is abandoned by not funding Family Builders.
• The question is no longer: Are we going to fund Family Builders, a successful and cost effective child welfare program? Rather the question is: Do we want to put children at serious harm and risk?
• The CPS system is again being stretched and stretched beyond its limits. This puts children at risk. Family Builders has proven its ability to succeed with families, reduce caretaker stress, and achieve Arizona's public policy goal of protecting all children by responding to 100% of CPS reports.
• Funding for Family Builders has proven to be cost effective and successful. Full funding should be restored assuring no child will be put at risk because of under funding of the CPS system. The system was working. Let's not break it again, and put children at risk, again.

References and Background Material:

Family Builders Program Evaluation Report No. 01-30. State of Arizona Office of the Auditor General, November 2001. (See page 1 and page 13. Nevertheless, the report goes on to note the very positive impact of Family Builders and the successful outcomes and impact of Fammily Builders on pages 19 - 19.)

Family Builders Program Annual Report for Fiscal Year 2001. Prepared by LeCroy and Milligan Associates, Inc. March 2002. (See especially pagaes 15 - 18 and the stories which follow.)

Child Welfare Reporting Requirements - Semi Annual Report: For Period April 1, 2001 Through September 30, 2001. Arizona Department of Economic Security, Division of Children, Youth, and Families, Administration for Children, Youth, and Families. (See pages 11 and 12 which outline families receiving services.)

Child Protective Services Chart: Number of Reports and Investigations, Yearly Changes - State Fiscal Years 1986 through 2001. Department of Economic Security Chart. Administration of Children, Youth and Families. (This chart tracks the investigation and response rate since 1986. Until Family Builders implementation, CPS never achieved its mandated goal of 100% response rate. Family Builders responds to almost 25% of all valid reports.)

Cost Benefit Analysis FY-2000 of CPS and Family Builders. Department of Economic Security Worksheet. Administration for Children, Youth and Families.

Proposed TANF Cuts Worksheet: Morrison Institute for Justice. February 2002.

SEE ALSO:

"Cuts Threaten CPS Offshoot." Arizona Republic Newspaper: Friday, March 8, 2002 Ashley Bach Page B4.

Child Protective Services Chart: Number of Reports and Investigations Yearly Changes State Fiscal Years 1986 to 2001.

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RBHA Proposal Process:

Regional Behavioral Health Authority Request for Proposals
Position Paper

This paper submitted by the Arizona Council of Human Service Providers (the Council) is the position of the Council concerning the Request for Proposal (RFP’s) process and the selection of, and implementation of, any new Regional Behavioral Health Agency (RBHA) contract. The Council will take this opportunity to establish a position on policy issues that will hopefully improve efficiency and effectiveness within the behavioral health delivery system throughout Arizona.

The Council members have many years of experience in providing quality behavioral health services throughout Arizona. These agencies for the most part are organized as non-profit corporations with community Boards of Directors. The vast majority of Council members have successfully demonstrated many years of committed service to their community. No matter what corporation is ultimately selected by the department, in any geographic area, the bulk of services will most certainly be provided through contracts with many of the Council’s members.

ADHS/DBHS has both the statutory mandate and responsibility to contract for behavioral health services through the selection and contracting process for a RBHA. With this understood, the Council and its members believe firmly that the selection and operation of any corporate entity to provide and/or manage the provision of behavioral health services can only be enhanced by an active and supportive role of the Council, ADHS/DBHS and the RBHA.

The Council would like to offer its assistance in enhancing the mental health service delivery system. A significant number of Council members have met to seek consensus on policy issues that all would be willing to support. It is hoped that these policy issues will improve the delivery system without a large influx of new funds.

The Council and its member agencies believe that the Council, the RBHA bidders and ADHS should establish a venue for dialogue with the express purpose of making sure all those who are involved in the behavioral health delivery system are unified when it comes to ensuring continued improvement of the system as a whole.

Below, please find a list of issues the Council strongly believes should be the expectation of ADHS/DBHS and all corporations wishing to respond to a Request for Proposal for a Regional Behavioral Health Authority contract in Arizona.

1. ADHS/DBHS should direct that all applicants for the RBHA contract must meet with representatives of the provider community and the Council, as part of the checklist for applicant RFP response completion. Meetings between the applicants and the Council should be official, open forum, and minutes recorded to ensure each applicant’s position related to behavioral health providers is clearly defined, openly discussed, and summarily reviewed as an integral part of the RFP process.
2. Cultural competency must be established at all levels within the behavioral health system.
3. The provider community should have a significant role in determining the service components that will be delivered by the RBHA and those delivered by community based providers. Where resources exist, clinical care should be delivered by community based providers. The RBHA should act as a resource and contract compliance agent for the provider network.
4. Providers and advocates should participate with the RBHA and ADHS/DBHS in service planning during the development of the behavioral health budget process or any increase in service funding working collaboratively and directly with the Legislative and Executive branches of State Government.
5. Quarterly financial reports by the RBHA should be made readily available for public review.
6. A true “partnership”, based on mutual respect and trust should be created between the RBHA, AHCCCS, ADHS/DBHS and the provider community.
7. The organization(s) selected to be the RBHA for a geographic area should work with ADHS/DBHS on a plan to reinvest a portion of any profits back into the Behavioral Health System and the community as a whole.
8. Representatives of the provider community should participate in the development of policy at the RBHA level. This can be accomplished by Board Membership (not-for-profit corporations) or by policy committee membership (for-profit corporations.

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Residential Care Position Paper

The Evolution of Residential Care in Arizona
Concerns and Solutions

**DRAFT**

Background
The Arizona Council of Human Service Providers (The Council), representatives of the residential provider community and the Board of Directors declare our full support of the Arizona Practice Model. Our organization recognizes and welcomes the additional services and new approaches to treatment that the Children and Family Teams (CFT) champions. We also recognize that the role and nature of residential treatment within this model will change. The residential network will support any modifications or changes in services that improve the quality of care for Arizona’s children.

The Council, and in particular, representatives of the residential provider community, seeks to become an active and valued participants in the design, development and implementation of this model. It is the intent of the Council to prepare and submit a plan for the involvement and integration of residential services into the CFT process.

It is the concern of the Council that some levels of residential services have not been involved in the development, training and implementation of the Arizona Practice Model. Concerns have been raised that those responsible for the implementation of model did not recognize or value the need or desirability of residential services. It has been stated that the Child and Family Team (CFT) can address and resolve the problems that the clients manifest in the family and the community without the need for out of home assistance. We respectfully disagree with this belief.

It appears that in the initial effort of using the CFT model there continues to be a need for various residential services. Clients continue to be suicidal, self destructive, dangerous to others, defiant, oppositional, delusional, homeless and psychotic to name only a few of the many issues that are in part treated and resolved in residential care. In fact there are some indications that the requests for residential services have increased, rather than diminished.

Accordingly we offer the following:

1. Inclusion in the Process
   It is the observation of the Arizona Council that residential service providers have not been minimally involved in the development and implementation of the CFT process, and only recently at that. As a significant part of the service delivery system, we believe it is imperative that we be actively involved in the development, training and implementation of this important initiative. In addition, the value and role of out-of-home placements in the continuum of care should be publicly recognized and supported by those in positions of authority, rather than being portrayed as a nemesis to be eradicated as quickly as possible. A model that maximizes the care and treatment of our clients needs to involve all the parties that impact and intervene in a child’s life.
2. Planning
   It is recommended that representatives of the Arizona Council and the residential service providers be included in any ongoing planning and development activities surrounding the implementation of the CFT model, especially when it comes to the role of out-of-home placements.
3. Training
   Once a clear understanding of the role of residential providers is established within the framework of the CFT initiative, a comprehensive training process must be established that includes all providers of residential care. Training should include, but not be limited to, the role of the CFT in treatment planning, expectations of the residential service providers as they support this process, and long term vision/expectations of this group of service providers.
   
   In addition, it has become apparent that many of the CFT participants, including the trained facilitators, do not understand the purpose and role of residential services. Expectations of treatment vary widely and in many cases are unrealistic and counterproductive. To promote positive relationships, and in the spirit of the CFT process, CFT members must have an understanding of residential care as gained through site visits and training including topics such as:
   
   Orientation and Introduction to Residential Care
   Levels of Residential Services.
   Goals/Expectations of Residential Treatment
   
   
4. Integration in the Model
   The Residential Providers recognize that their role in the system will dramatically change once the CFT model is properly implemented. It is important that a systematic and closely coordinated effort be facilitated that includes the expertise and creativity of the Residential Community. This model, to be successful, requires a productive collaboration of all parties working together effectively and share common goals.

There are many challenges and barriers to developing a system of care that incorporates Out-of-Home services into the CFT process. The Council offers its resources and that of its membership to the Division of Behavioral Health Services, and designees, to assist in the implementation of a strategy that integrates residential services in the continuum of care for our children.

Created and submitted by the Arizona Council of Human Service Providers Ad Hoc Committee on Residential Care. Approved by the Arizona Council of Human Service Providers Board of Directors and Member Agencies.

Council Board Chair
Council CEO
Residential Care Committee Chair

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Changing Arizona
One Vote at a Time

How YOU Can Change the Future of Arizona

The Concern
A fiscal crisis with a potential budget deficit of over one billion dollars! Historically, when Arizona has faced a financial crisis, the lowest priority has been given to our most vulnerable citizens.

Behavioral health, substance abuse treatment, protection of children, prevention, early intervention and justice services are an essential part of a flourishing economic and social Arizona community. Everyone in need of these services should have access to them.

The Solution
A grass roots effort to influence the electoral process by supporting candidates for public office who have demonstrated an ability to make progressive decisionson a variety of issues, based on the best and most complete information available. This grass roots effort will support candidates through fund raising efforts, petition signings, direct campaign aid and other approved activities. Take advantage of this opportunity to get to know your elected officials and influence the future of Arizona.

What YOU Can Do
GET INVOLVED: By completing our online registration form, you commit to assist candidates in your legislative district who support the issues stated above. You will work with many fellow citizens in a 'network of activists' who will work together to create a legislature that is responsive to the needs of your community, open to the input of the average citizen and have the ability to make informed decisions - not based on any particular ideology or single issue agenda.

It takes less than three minutes to complete our online registration form. After signing up, the Arizona Council of Human Service Providers will correspond with you frequently about activities in your legislative district which will include candidate profiles, candidate positions on identified issues, previous voting records and any other relevant information.

Join us in changing the Arizona political environment !!
Start your online registration by clicking the link:

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Prevention Postion Statement

The Arizona Council of Human Service Providers has presented a Prevention Position Statement, which can be opened in a separate, printer-friendly, window by clicking on the photograph on the right.

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