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Home › Forums › Enrollments, Prior Authorization, & Bureaucracy › SMI designation
Tagged: SMI
Arizona‘s behavioral health system (BH) has failed us so many times it’s difficult for me to pick out a particularly one more egregious example than another. When our son first became symptomatic with his disease, which turned out to be you schizoaffective disorder, we had to fight the BH system. At first they denied him being seriously mental ill at all and, after two appeals, we were scheduled to go before an administrative judge when, for some unknown reason, somebody canceled the court hearing and he was finally determined to be SMI. Our son was assigned to a Choices ACT team and our experience with that ACT team was even worse, if anything, then before he was determined to be SMI. They did not provide the services he was entitled to, and the head of the ACT team (clinical director) was extremely unsympathetic, uncooperative, and frankly incompetent. Our son was evidently a “difficult“ patient and the ACT’s team solution was to decide, all of a sudden, that he was not sick and no longer seriously mentally ill.This assessment occurred during a regular staffing when they wanted five minutes alone with him before the beginning of the meeting. They then told us that they were canceling the meeting and that they had “determined” that he no longer was seriously mentally ill. They tried to refuse him services. This, of course, after years and years of him being denied services through our group health insurance on the private side due to non-compliance with parity law. This decision, by his “supportive” ACT team was eventually overturned after review by another psychiatrist.
Arizona State University Watts College of Public Service and Community Solutions and its Morrison Institute for Public Policy proposes a new approach to describing the costs associated with chronic mental illness. Rather than a top-down analysis that estimates the overall cost of CMI across the state, this analysis will utilize a bottom-up approach that will examine the costs associated with the individuals with a CMI as they move through Arizona's criminal, public benefit, and physical and behavioral health systems. This approach lends itself to a highly-graphic system map and/or flow charts that could be enhanced with animation for use in PowerPoint display.
For this study's purposes, chronic mental illness will be defined as a subset of the population with serious mental illness that is unable to settle into a stable living arrangement. The symptoms and behaviors exhibited by people with CMI make it difficult for them to remain either in an independent household or group housing for an extended period. This instability leads to the frequent use of high-cost services from various medical, behavioral, and criminal justice resources.
The total costs of CMI are challenging to calculate because they are spread over an extensive network of services, and the nature of CMI means that these services are repeatedly accessed. Recognizing that each individual will process through this system in a slightly different matter, we will take a bottom-up approach to estimate these costs, focusing on the values of an individual at each node of the system.
We will hold a meeting to reveal the study findings. Subscribe to our newsletter for notification.