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Board of Directors 
Michael Shafer, Chair  
Joshua Mozell, Vice Chair  
Kristina Sabetta, Secretary  
Jason Bernstein, Treasurer

Jack Beveridge
Max Dine, M.D.

Sheri George
Charles Goldstein, M.D
Laurie Goldstein

Emily Jenkins
Marcus Johnson
Barbara Lang

Karen Pitico
Clarke Romans
Coming Events

Save the Date for May 20th & 21st, 2016 MHA-AZ's SEEDS Conference  
 
December 16:
The Williams Parent Connection.  A support group for caregivers who have children with behavioral healthcare needs will be meeting from 10AM - 12PM at the Family Harvest Church, 220 S 7th Street, Williams. For information, call (928) 379-5077.

December 17: 
The Network Meeting for Empowerment Systems will meet at 2066 W Apache Trail Ste 116, Apache Junction  from 1:30 to 3:30 pm.  For more info  contact truiz@emsysonline.org. This is a collaboration & sharing of resources between public & private agencies, businesses, government agencies & faith based programs. 

December 19th & 26th  
Mobile Food Pantries, will be at Pilgrim Rest Baptist Church, 1401 E Jefferson St, Phoenix from 11 am to 1 pm. No cost for fresh fruits & vegetables. Serves all families & individuals regardless of income, no ID is required. More info familyservices@pilgrimrestphx.org.

January 13:
A free training on "I Want to Vote" from 2 pm to 5 pm at the Viscount Suite Hotel 4855 E. Broadway, Tucson. Targeted to individuals with a disability.  Click here to register for the event.
 
January 20 or 21st: Trauma Informed Care to Daily Work Activities (6 hour training) from 9 am to 4 pm will be offered at MHC Healthcare 13395 N Marana Main Street, Marana. Training is for non-clinical staff to learn the basics of trauma informed care & how to apply the principles of trauma informed care to daily work activities regardless of role. To register click here.

January 19, 20, 26, 27, 28, February 2, 3, 9, 10 & 11:   
A Support Specialist Institute offered at SEABHS, 4755 Campus Drive, Sierra Vista. Training is for DBHS Certified Peer Support Specialists.  Integrated Healthcare Recovery is the topic to be covered. Contact Sharon Simmons at 520-626-7473 email sharons@email.arizona.
edu.

Family Involvement Calendar for Phoenix or for Northern Arizona.


Regional Behavioral Health Authority Calendars:

Cenpatico Community Events Calendar 
 
Mercy Maricopa Community Events Calendar 
 
Health Choice Integrated Care Community Events Calendar 
November 15, 2015
 
  Is the Glass Half Full or Glass Half Empty?

Earlier this month, the U.S. Senate voted 52 to 47 to repeal portions of the Affordable Care Act (ACA) also known as Obamacare.  The U.S. House of Representatives is expected to act by mid-December. 

If signed into law, this action would end coverage for 17 million individuals. The ACA would not be fully repealed, but it removes some key provisions.  Of particular interest are the plans to: 1) eliminate the subsidies provided to about 6 million Americans buying their insurance on the Marketplace when it is not offered by their employers; and 2) halt expansion of Medicaid by ending the federal subsidies over the next two years.   The Senate vote is the latest part of the five-year-long effort by Congress to veto all or parts of the ACA.  

When the bill hits the President's desk and it will be vetoed.  Let me say that again, the bill will be vetoed.  But the public debate will not end, it will simply move to the 2016 Presidential and Congressional election cycle.

Since the passage of the ACA in 2010, it has been challenged twice before the U.S. Supreme Court and legal challenges are ongoing in various courts around the country. 

The Supreme Court's first ruling in 2012 upheld that the health care law's requirement that most Americans obtain insurance or pay a penalty was authorized by Congress's power to levy taxes.  The court did decide that the ACA's requirement for states to expand Medicaid actually exceeded Congress' constitutional authority because of the threat to states' established eligibility to receive the existing federal payments.   A second Supreme Court ruling in 2015 confirmed that tax subsidies to help poor and middle-class people buy health insurance through the Marketplace applied nationwide, regardless of who operated the Marketplace.  

Following the 2012 ruling, many states did not expand their Medicaid program.  Fortunately, Arizona did expand the state's Medicaid program (known as AHCCCS) which became effective January 2014, resulting in almost 79,000 Arizonans now being enrolled in the program.  Arizona joined 30 other states in choosing to expand its Medicaid program.   Expansion discussions are underway in three other states (Utah, Wyoming and Louisiana).  According to the Kaiser Family Foundation, as of October of this year, more than 3 million people in the 17 states that didn't expand their Medicaid program and who don't qualify for the Marketplace are in the "Medicaid gap" without insurance coverage. 

The Marketplace is in the midst of its third year of Open Enrollment.  The Marketplace system has faced challenges beyond the premium tax credit question.  During the first enrollment cycle there were major computer problems that brought the system to its "knees".  Other challenges have resulted in some states that initially operated their own Marketplaces having thrown in the towel due to cost and technology demands.  Even with those major bumps in the road, last spring, on a national basis, nearly 11.7 million consumers obtained health insurance coverage through the Marketplace, according to the U.S. Department of Health and Human Services.  About 65 percent of those enrolled qualified for the premium tax credit and more than half paid $100 or less per month after those tax credits.  The outcomes for this year's enrollment cycle are not yet available, but analysts worry it will be increasingly difficult to "lure in" the remaining uninsured.

The ACA has faced other criticisms.  Just a flavor of those the concerns include:  1) news that premiums for this year increased to the point of making coverage out of reach for some families even with the premium tax credit; 2) the demise of Health Insurance Cooperatives in many states (including Arizona) because of the underpricing and the costs incurred by these start-ups; and, 3) United Health Care (the nation's largest single health insurance carrier) announcing a plan not to participate in offering insurance on the Marketplace next year.
There is, however, good news that can make us hopeful about the ACA.  Those outcomes include:  1) the percentage of individuals without health insurance has dropped; 2) the percentage who reported not being able to afford care has dropped; 3) there has been an increase in the number seeking preventative care; 4) an increase in the number who have a regular doctor and 5) a recent study has shown that more women are receiving early treatment for cervical cancer because of the ACA. 

It is still too early to know how these swirling changes will impact the ACA's future and ultimately access to health care for individuals either through employer sponsored health insurance, the Marketplace, Medicare or AHCCCS.  Our challenge and responsibility is to understand and participate in the public debate on the delivery of quality and efficient health care. 

The question remains, for you and for me, is the glass half full or half empty.  What is your vision of how care should be delivered and paid for?    
Peer Career Advancement Academy Session Done
The Arizona Department of Health Services/Division of Behavioral Health awarded a two-year contract to the Arizona State University Center for Applied Behavioral Health Policy (ASU CABHP) to establish a Peer Career Advancement Academy (PCAA). The purpose of the academy is to equip certified Peer Support Specialists to further their careers by providing advanced training and educational opportunities. Peer Support Specialists are individuals in recovery from mental illness and/or addiction who provide support to individuals receiving services from behavioral health and other health care and human service providers.  
 
ASU partnered with over 50 community subject matter experts, including peers support specialists, to develop, design, and deliver four courses on supportive housing, advocating for persons with a serious mental illness, health and wellness, and supported employment.  Each course consisted of 24 hours of classroom instruction, with additional time for homework, job shadowing, and learning circles.   So far there have been more than 70 graduates from across Arizona.

Agencies involved in the curricula development, delivery of modules, and support of courses continues to grow and includes thus far:  the ADHS/DBHS Office of Individual & Family Affairs, Office of Human Rights and Office of Housing and Employment; Marc Community Resources;  ABC Housing; Recovery Innovations; Frazer, Ryan, Goldberg & Arnold, L.L.P.; Community Legal Services; Arizona Center for Disability Law; Arizona Center for Law in the Public Interest; CHEEERS Recovery Center, Recovery Empowerment Network;  S.T.A.R.; Lifewell; MMIC Office of Supported Employment; Vantage Point Behavioral Health Resources; OptumHealth;  Arizona Department of Economic Security's Rehabilitation Services Administration; Crestline Advisors; Our Club House/Café 54; Ability360; and Focus Employment.  

"One of the most powerful outcomes of peer support is that it has a mutual benefit. Peers not only help others, they help themselves," says Vicki Staples, Associate Director for Clinical Initiatives for the CABHP.   Peer support services have been shown by Solomon (2004) to reduce hospitalizations, improve social functioning, reduce substance use, and improve quality of life. 

"This is a great collaboration between state agencies, community providers and advocates to build a program from the ground up with community input," Staples adds. "Ongoing community support is critical to its future."  We are excited with the new partnerships developed between so many community agencies and ASU to ensure students have access to the most current information and resources available in their areas of interest.  For more information about the ASU Peer Career Advancement Academy, contact Vicki Staples at vicki.staples@asu.edu
     NAZCARE Deaf and Hard of Hearing Services

NAZCARE, Inc. began providing services for the deaf and hard of hearing (D/HH) to meet the needs of D/HH peers. There is a lack of resources and no funding to meet interpretation needs. NAZCARE had several peers who were deaf and needed peer services, advocacy and social integration. The barriers were huge: lack of people knowing sign language, peers insisting on qualified and certified interpreters and difficulty over-coming barriers around Deaf Culture.

NAZCARE felt frustration and barriers on every level: peers, family members, the system of care and other providers, yet the need was too huge to ignore and could not be ignored. Deaf peers tended to disproportionately deal with depression and social isolation over longer periods of time. NAZCARE found when we included the D/HH peers in groups and activities there was a reduction in depression, lift in moods and greater social interactions.  The challenge: how to make it happen.

NAZCARE hired a Director of Deaf and Hard of Hearing Services, Laura Richard. She worked with Purple and Sorenson Video Businesses to gain grants to receive video translation services. This allowed NAZCARE to: 1) begin a deaf and hard of hearing warm line to reach out to D/HH.  The first call was a crisis call supporting the huge need for services. 2) provide a public system so anyone who is D/HH can walk into New Directions in Kingman, New Hope in Prescott and Rising Star in Apache Junction and get an immediate access to interpretation services with a qualified and certified interpreter, and 3)  most importantly, it allows D/HH staff to be able to be fully integrated into all aspect of NAZCARE and all meetings.

This process has not been easy, we still face challenges and receive no funding or support. We also face hiring challenges since most people who know Sign Language can get jobs that pay much higher than NAZCARE's general staff, and with no additional funding or support we struggle to find D/HH staff. And, we lack referrals and acceptance by providers. 
Holiday Coping
Ways to Stay Calm During the Holidays. Many find the holidays can be a very happy and joyous time with family and friends, but it can also be stressful. Stress levels go up and coping abilities go away.  Instead of accepting stress look at this resource as a way to put aside those feelings of being overwhelmed, depressed or lonely, check out 8 Ways to Stay Calm During the Holidays.

Happy Holidays! 

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 | | sissons8@cox.net |