Tag Archives: arizona department of health services

Chandler Regional Hospital

Kitchell finishes 171KSF patient tower at Chandler Regional

Kitchell recently completed a 171,000-square-foot expansion at Dignity Health Chandler Regional Medical Center, adding 96 beds and bringing the hospital’s bed count to 339, while adding and expanding comprehensive services.

The ICU at Chandler Regional Medical Center

The ICU at Chandler Regional Medical Center

“Chandler Regional is truly a community hospital with more than 50 years of history in the East Valley,” said Tim Bricker, president and CEO of Chandler Regional and Mercy Gilbert Medical Centers. “The City of Chandler is growing at 1.7 percent per year which adds approximately 5,000 new residents annually.

This new tower and the services we’re able to provide as a result, exemplifies the city’s growth. We’re proud to be expanding to serve the health care needs of our community.”

The $125-million project began in December 2011, will add more than 200 new employees. The five-story addition includes 96 inpatient beds; an expanded emergency department with additional patient rooms, four trauma bays, two helipads and an expanded radiology department; expanded surgical services with six new operating rooms; and a new and expanded Intensive Care Unit with 32 beds.

Chandler Regional is the latest project in the growing portfolio by the design-build team of Kitchell and Orcutt | Winslow Partnership. The team is also responsible for several renovations and additions at St. Joseph’s Hospital and Medical Center in Phoenix, Dignity Health-St. Rose Dominican, Siena Campus in Henderson, Nev., and is also working at Mercy Gilbert Medical Center.

Chandler Regional Medical Center

Chandler Regional Medical Center

Chandler Regional first opened its doors in 1961 with 42 beds, 25 employees and 91 volunteers at what is now McQueen Rd. and Chandler Blvd. The facility moved to its current location in 1984 and by 1996 received $40 million in bonds which was used for major expansion over the next 10 years. In 2002, the hospital added a 140,000-square-foot tower that included a women’s center, outpatient diagnostic imaging, and dedicated emergency CT and MRI.  By 2011, the hospital added two new labs and an additional nine-bed holding unit to its Cardiac Catheterization Laboratory. The following year, Chandler Regional opened a Neonatal Intensive Care Unit with 12 private patient rooms featuring overnight accommodations.

The hospital began operating as a Level I Trauma Center in March 2014 after being granted provisional designation by the Arizona Department of Health Services. Official designation is expected later this fall.

childbirth

Arizona achieves substantial reduction in preterm birth

Nearly 1,000 babies were spared the health consequences of an early birth and potentially $52.7 million in health care and societal costs were avoided in Arizona, according to the March of Dimes.  Based on 2012 preliminary data, Arizona has reduced its rate of preterm birth from a rate of 12.7% in 2009 to 11.6% in 2012 — an 8.7% reduction. Arizona Department of Health Services and March of Dimes Arizona Chapter will today receive the March of Dimes Virginia Apgar Prematurity Campaign Leadership Award, for lowering their preterm birth rates by more than 8 percent since 2009.  Arizona’s long-term target of a premature birth rate is 9.6 percent by 2020.

“This award reflects a team effort between March of Dimes, the Arizona Department of Health Services, Arizona Perinatal Trust as well as our health care organizations and agencies that have joined us to fight premature birth in Arizona,” Will Humble, Director, Arizona Department of Health Services.

The Virginia Apgar Award is given to recognize states that accepted and met a challenge from the March of Dimes and the Association of State and Territorial Health Officials (ASTHO) to lower their preterm birth rates 8 percent between 2009 and 2014.  “This progress shows that when infant health becomes a leadership priority, significant progress is possible and families and babies benefit,” says Dr. Paul E. Jarris, executive director of ASTHO.

The award is named in honor of Virginia Apgar, MD, who developed the five-point APGAR score to evaluate an infant’s health at birth, and who served as vice president for medical affairs of the March of Dimes.

Health officials in Arizona are worked closely with March of Dimes staff and volunteers on the “Healthy Babies are Worth the Wait” educational campaign, which urges hospitals, health care providers, and patients to follow the American College of Obstetricians and Gynecologists guidelines and reduce medically unnecessary elective deliveries before 39 weeks of pregnancy.  The final weeks of pregnancy are crucial to a baby’s health because many vital organs, including the brain and lungs, are still developing.

The March of Dimes says that if every state met the 8 percent challenge, it would push the nation’s preterm birth rate down to about 11 percent, giving an estimated 40,000 more babies a healthy start in life. Such a change could save about $2 billion in health care and socio-economic costs, the March of Dimes says.

Preterm birth (before 37 completed weeks of pregnancy) is a serious health problem that costs the United States more than $26 billion annually, according to a 2006 Institute of Medicine report.  It is the leading cause of newborn death, and babies who survive an early birth often face the risk of lifelong health challenges, such as breathing problems, cerebral palsy, learning disabilities and others.

The March of Dimes is the leading nonprofit organization for pregnancy and baby health. With chapters nationwide, the March of Dimes works to improve the health of babies by preventing birth defects, premature birth and infant mortality.

In 2013, the March of Dimes celebrates its 75th Anniversary and its ongoing work to help babies get a healthy start in life.  Early research led to the Salk and Sabin polio vaccines that all babies still receive.  Other breakthroughs include new treatments for premature infants and children with birth defects.  About 4 million babies are born each year in the United States, and all have benefitted the March of Dimes life saving research and education. For the latest resources and information, visit marchofdimes.com/arizona or nacersano.org.

childbirth

Arizona Community Foundation awards $25K to AFHP

The Arizona Community Foundation has awarded the Arizona Family Health Partnership (AFHP) a $25,000 grant to implement a statewide public awareness and education campaign for young women about the importance of taking B vitamin folic acid before and during pregnancy to prevent birth defects.

Research consistently shows that the highest rate of unintended pregnancies is among women 18 to 24, a population with the lowest awareness of the benefits of folic acid and its role in preventing birth defects.  Folic acid has been proven highly effective preventing birth defects known as neural tube defects (NTDs), which affect the brain and spine.

AFHP will use the funds to activate the Project B Aware campaign, first piloted in 2010 in Phoenix-area high schools by the March of Dimes Arizona Chapter and the Arizona Department of Health Services through a one-time federal grant.

The result of the pilot program was a 50 percent increase in knowledge about folic acid among participating high school students.

“Young women, particularly those who are low-income, are at high risk of unplanned pregnancies and at higher risk of having a baby born with an NTD due to their lack of knowledge about folic acid,” said AFHP CEO Brenda “Bré” Thomas.  “Despite being described as an ‘astounding public health silver bullet’ by a 2008 Gallup poll, only 39 percent of women ages 18 to 45 take folic acid daily.”

Research shows that lack of awareness and lack of advice in recommending foliate supplements before and during pregnancies is the primary reason young women don’t take folic acid.

“This important funding from the Arizona Community Foundation will enable us to use the previously created March of Dimes Folic Acid 400 curriculum to reach a much broader statewide audience with this critical health information,” Thomas said.
AFHP will use the March of Dimes-developed curriculum that has been adapted for teens.
The Project B Aware program includes a folic acid pre-test administered to all students and teachers, a PowerPoint presentation about folic acid with interactive student participation, a post-test, a list of foliate-rich foods and information about the importance of taking folic acid daily, and a survey to assess the presentation.

AFHP will recruit and train folic acid educators, identify and coordinate program presentations at specific high schools and administer the pre-and-post tests.  The program ends in April 2014.  AFHP will partner with Kappa Delta Chi sorority to provide the folic acid education.

AFHP expects to complete presentations to approximately 1,400 students.
For more information about the Arizona Family Health Partnership and Project B Aware, visit www.arizonafamilyhealth.org or call (602) 258-5777 in Maricopa County and (888) 272-5652 outside Maricopa County.

Trauma Program Manager Lori Moxon, RN, left, with (from left) John C. Lincoln Deer Valley Hospital CEO John Harrington Jr., Level III Trauma Medical Director Ian Thomas, DO, ADHS Trauma Development Section Chief Daniel Didier, John C. Lincoln Trauma Services Medical Director Alicia Mangram, MD, and Deer Valley Hospital Medical Director Mary Ann Turley, DO, celebrate the presentation of the hospital’s Level III Trauma Center designation from the State of Arizona.

John C. Lincoln Deer Valley Hospital now Level III Trauma Center

The Arizona Department of Health Services Bureau of Emergency Medical Services and Trauma Systems Monday granted John C. Lincoln Deer Valley Hospital’s application to be designated as a Level III Trauma Center, hospital CEO John L. Harrington Jr. announced.

The first trauma patient arrived just hours later.

Patient care services in the Deer Valley Emergency Department have been expanded to qualify for the higher Level III Trauma Center designation and to better serve people injured in the North Valley. Emergency care for traumatically injured patients at the Deer Valley Hospital has been upgraded with additional resources and staff education.

“My goals are to enhance the quality of care patients already receive at the Deer Valley Hospital by using my 15 years of trauma experience to develop a core team of specially-trained trauma staff,” said trauma program manager Lori Moxon, RN, BSN.

The Level III designation requires that surgeons on call have Advanced Trauma Life Support (ATLS) accreditation from the American College of Surgeons. ATLS teaches a standard approach for trauma assessment and treatment so the most time-critical interventions are performed first.

“Our program will be even better than that,” said hospital Medical Director Mary Ann Turley, DO. “At Deer Valley, our trauma doctors –  available within  30 minutes – will be the same board certified trauma surgeons who care for patients at the Level I Trauma Center at John C. Lincoln North Mountain Hospital.”

John C. Lincoln’s trauma surgeons hold dual board certification in both critical care and trauma surgery. Trauma orthopedic surgeons and anesthesiologists will be on call.

According to Alicia Mangram, MD, care at the Level III Trauma Center at Deer Valley will be coordinated with higher acuity medical services available at North Mountain’s Level I Trauma Center, where she is medical director.

“This is the first time that a Level I Trauma Center has collaborated with a Level III Center to ensure the same quality and best clinical practice for our patients,” Harrington said. “It is a very exciting resource, not only for our patients, but also for the EMS crews who provide emergency response service for our community.”

With its plans to transform itself into a Level III Trauma Center, Deer Valley is launching a G-60 program for trauma patients aged 60 and older. The program, instituted last year at North Mountain, is designed to improve outcomes and reduce mortality and morbidity for older trauma patients by providing more intensive and coordinated inpatient care.

The Level III Trauma Center will also offer injury prevention community outreach programs similar to those presented by North Mountain’s Level 1 Trauma Center, Moxon said. “Since this will be a network endeavor,” she explained, “our plans are to incorporate the many excellent community educational programs developed by injury prevention/outreach coordinator Kim Shatto, RN BSN, that focus on the cause and prevention of our major traumatic injuries.”

The facility will also provide data about patients, their diagnoses, care and outcomes to the state Department of Health Services Bureau of Emergency Medical Services and Trauma Systems.

medical.marijuana

Only 27.1% of medical marijuana cardholders are women

Two years after the legalization of medical marijuana in Arizona, the use of the plant is still taboo for many members of a group that makes up half of the population: women.

Only 27.1% of medical marijuana cardholders are women, according to statistics released by the Arizona Department of Health Services. Several factors, including the system the DHS has set up and certain aspects of marijuana culture, may explain this disproportionate number.

Ashley and Rachel Beeder are sisters who co-own Green Dignity Medical Center in Tempe, a clinic that helps patients with qualifying medical conditions become cardholders. The Beeders employ three naturopathic doctors, all of whom are women. Most of the patients that go in to get their cards, however, are men, Ashley Beeder said.

She believes a large reason why women are hesitant to become patients is that they’re afraid.

“It’s fear, fear of being labeled as a ‘druggie’,” Ashley Beeder said. “Guys put themselves in risky situations, they’re not scared of pot. But even women who have smoked don’t want their name in a database.”

Ashley Beeder said she has only seen two women go in to get their cards, although women go in quite often just to ask questions.

Dr. Kristi Norris also said that many women are afraid of the social stigmas that surround marijuana use.

“Women are supposed to be the caregivers, we hold ourselves to a higher standard,” Norris said. “The fact that marijuana is still [thought of] as a ‘drug’ makes it unacceptable for women to be using it.”

Ashley Beeder thinks this disproportion may also be caused by the types of medical conditions that qualify people to become cardholders. While the DHS accepts 13 debilitating conditions, including cancer, glaucoma, HIV/AIDS, chronic pain, severe nausea, and severe muscle spasms, the lack of any mental illnesses on that list eliminates the possibility of becoming a cardholder for many women.

“Depression is a condition in California but not here. If it’s approved somewhere else why isn’t it approved here?” Ashley Beeder said.

Depression is a mental illness that affects one in eight women at some point in their lifetime, and twice as many women as men, according to the National Alliance on Mental Illness. The California Department of Public Health gives room in their list of qualifying conditions to allow for mental illnesses such as depression. The DHS, on the other hand, only accepts requests for adding conditions in January and July and requires applicants to provide scientific research that proves marijuana can treat that condition.

Rachel Beeder believes that another reason for this is the way medical marijuana is marketed.

“They use a hot girl in a bikini [as advertising] to bring in men,” Rachel Beeder said. “The whole medical marijuana industry is marketed towards men.”

However, there are several health benefits that marijuana can have for women, Norris said.

“It helps people with their appetite if they’re going through chemotherapy. Even if it wasn’t approved by the state for anxiety, it helps with that,” Norris said.

Recent scientific studies have found that cannabidiol, a compound found in cannabis, was able to stop the spread of aggressive breast cancer cells, according to an article published in the UK Daily Mail on Sept. 20. The study was published by a team of doctors at the California Pacific Medical Center, and is based on five years of research.

Norris said she has offered to hold classes through Phoenix March, an organization of women who advocate for marijuana as a safe alternative to prescription drugs, in order to educate women about not only marijuana but other alternative medicines as well.

“When it comes to pain, doctors prescribe people oxycodon and morphine and that’s acceptable…pretty soon you’re taking a handful of medications and you still have the pain,” Norris said. “The whole idea is to get rid of their pain, not just to drug them.”

The Green Dignity team believe that it’s important to inform and educate women about the benefits of marijuana. They are all members of Phoenix March, and participate in their bi-weekly lunches.

“I think [women] are closed-minded about it, especially older women.” Rachel Beeder said. “We need to band together and spread knowledge and truth.”

healthcare

Valley medical centers seek trauma designation

Two medical centers in Maricopa County plan to seek trauma designations from the Arizona Department of Health Services’ emergency medical bureau.

Chandler Regional Medical Center plans to open a Level I trauma center. Its sister hospital, Mercy Gilbert Medical Center, is planning for a Level III facility.

For Chandler Regional, a Level I designation would mean it could treat the most life-threatening injuries. Medical and surgical specialists would be on hand around the clock.

Currently, there are six Level I trauma centers in Phoenix and one in Scottsdale.

Elected leaders and representatives from the medical community have been advocating for a Level I trauma center in the southeast part of the Valley.

Medical center officials cited a 2012 state report that showed only 42 percent of critically injured patients in Maricopa County arrived at a Level I center within an hour of being injured.

pool safety

Pool Safety: Preventing Child Pool Drownings

With the summer just beginning, practice pool safety; ensure your pool and spa area in your backyard is safe, to prevent child drownings.


So far this year, 14 pool-related drowning incidents by children have occurred in the state. In 2011 alone, 27 children died from drowning, according to the Arizona Department of Health Services (AZDHS).

This summer, keep your kids safe (especially around the backyard pool) by taking the following precautions, provided by the Arizona Insurance Council (AIC):

  • Add a barrier between the pool and your home; make it difficult for your kids to get to the pool by installing a pool fence. Ensure it has self-closing, self-latching gates and a door alarm that sounds when a door is opened from inside the home, says Ron Williams, executive director of the AIC.
  • Secure all doors, gates and pets doors that lead to the pool area.
  • Ensure your pool has compliant drain covers.
  • Keep toys away from pool areas, and secure spas with childproof covers.
  • Teach children how to swim.
  • Take the phone with you to the pool; in case of an emergency, dial 911 immediately.

The U.S. Consumer Product Safety Commission (CPSC) recommends that you have a pool safety toolkit near your pool or spa so you are ready to respond quickly to anything that may happen:

  • A first aid kit
  • A pair of scissors to cut hair, clothing or a pool cover, if needed
  • A charged portable telephone to call 911
  • A flotation device

For more information about AIC or the CPSC, visit azinsurance.org or cpsc.gov, respectively.

For more information about pool safety, visit poolsafely.gov.

Independent Living, Q&A with Vi at Silverstone

Transitioning A Parent To Independent Living, Care Facilities

Coming to terms with moving a parent into independent living, a care facility can be personal and enriching

The decision to move a parent from their residence into a retirement facility is not easy to come to terms with. However, at Vi at Silverstone, a resort-style living facility in Scottsdale, the change is made easier. Gail Rankin, executive director of Vi at Silverstone, discusses how the transition is both a personal, yet positive life decision.

Q: How does one know if his or her parents are in need of a facility?

A: Without community, we are targeted towards independent living. We offer an enriching lifestyle for older adults. They are making (the decision to move into a facility) for themselves, without all the emotions and trauma of someone who is looking for a nursing facility.

Q: What are the different options available?

A: We are a continuing care retirement community. We offer 25 different floor plans for independent living. We also have a care center on site, offer assisted living, a memory support unit for (people) with Alzheimer’s, and also a skilled nursing unit.

Q: What amenities should one look for in a facility?

A: I think that in our case, residents who choose this lifestyle really need to find a fit for them. They need to find a community that offers things that are important to them. We offer a full-time fitness instructor, gourmet dining, three dining venues, a bank on premises, salon and spa, housekeeping services, all maintenance. They enjoy a very enriching lifestyle. It is very much resort-style living.

Q: What are the costs for a parent to stay at your independent living facility?

A: They can start as low as $3,000 and range to $5,000 per month for independent living. This includes a meal a day, housekeeping, and maintenance. It’s a very worry-free lifestyle. (People) are able to enjoy their life without the burden of home ownership.

Q: What factors should be considered when making the final decision to move a parent into an adult care facility?

A: One of the benefits of making a decision for yourself is that you can find the best fit for you. We offer many opportunities for residents to make connections. It’s a very personal decision, but they need to do their homework. Most of the people that we see are very well informed. There’s the Arizona Department of Health Services, FAQs, and surveys of care venues to look at.

Q: Is there anything else that you would like to add?

A: The folks that come to us for independent living are looking for a life-care contract. They want to be in a community to enjoy the things that they’ve always enjoyed.

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Vi at Silverstone

23005 N. 74th St., Scottsdale
(888) 719-0942
www.viliving.com

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Medical Marijuana, AZRE Magazine May/June 2011

Medical Marijuana Dispensary Operators Deal With Regulations, Landlords

Don’t look for medical marijuana dispensaries to pop up next door to your neighborhood drug store anytime soon.

Cities are wrestling with a host of issues to determine where the new businesses can set up shop, even as the Arizona Department of Health Services tries to figure out who can operate them and who can use them.

After publishing preliminary guidelines, followed by a period of public comment, ADHS issued start-up regulations on March 28.

The state agency divided Arizona into 126 community health analysis areas, or CHAAs, based on population density. The agency will issue a maximum of 124 dispensary licenses, with no more than one license within a CHAA, says Will Humble, ADHS director.

State regulators will start taking applications on June 1 and will dole out licenses starting in August after vetting the sites and the potential business owners, Humble said.

If more than one acceptable application is submitted within a CHAA’s boundaries, a lottery will decide who gets the license, he added. The first dispensary in the state could debut by fall. Humble said he expects to issue 90 to 100 licenses within the first full year of start-up. After that, ADHS will revisit the rules to determine if some tweaking is necessary.

“By the end of a year, we’ll know where the qualified patients are,” he says.

Proposed dispensary sites must comply with the zoning requirements of the municipalities they fall into, so cities have been scrambling to get zoning in place and start vetting potential locations, otherwise, they risk the state issuing licenses in unsuitable areas, says Thomas Ritz, Glendale senior planner.

Glendale passed zoning guidelines on Feb. 22, and the rules are similar to those of most cities in regard to type of site, such as office or industrial. In addition, a dispensary must be 1,320 feet from schools, 500 feet from residences, and one mile from another dispensary, Ritz says.

Scottsdale will allow medical marijuana dispensaries on campuses, and within 2,000 feet of another dispensary. Tucson will allow them to do business in retail centers, as long as they are the required distance from schools and residences.

Tucson, among the first off the block to embrace the new businesses, completed its zoning rules in November, says Craig Gross, Tucson’s deputy director for planning and development. But Gross pointed out the complexities of working within the state’s guidelines.

Tucson has 10 CHAAs within its city limits, he added, but because CHAAs are based on population density irrespective of municipality boundaries, nearly all are partly in other cities, towns or even unincorporated county land.

“That makes it interesting,” Gross says.

Tucson has a handful of applications and a dozen or so serious inquiries in some stage of processing, Gross said, but he doesn’t know if there are sites also in process by other government agencies for the same CHAAs.

And in Scottsdale, which houses two CHAAs but has about the same number of applicants or pre-applicants in the pipeline as Tucson, most of its potential operators are opting for the Scottsdale Airpark area, says Kira Wauwie, project coordinator for the city’s dispensary rollout.

Meanwhile, Glendale is bracing for a deluge of dispensary operator wannabees.

“We had a neighborhood meeting, and we had about 35 people learning, listening — a healthy stream of people asking questions,” Ritz says. “We’ll see how many turn in applications.”

But first those hopeful applicants have to snag sites that conform to state and city regulations. And even in this high-vacancy real estate market, potential landlords are leery of housing dispensaries.

“I’m surprised that individuals are finding it tough to get into a building they like,” Gross says. “Property owners don’t necessarily want to rent to them.”

Arizona real estate brokers confirm that many building owners are reluctant to lease space for dispensaries, despite the numerous hoops the potential business owners need to jump through to get a license.

Gross says building owners are slow to the table because the process is so new, and he thinks more will opt in now that ADHS rules have been set in stone — or at least for a year.

For more information about medical marijuana dispensaries, visit the Arizona Department of Health Services’ website at azdhs.gov.

AZRE Magazine May/June 2011

 

Arizona Ambulance - AZ Business Magazine Mar/Apr 2011

Arizona’s Life-Saving Trauma Units Take Hours Of Hard Work And Planning

When Disaster Strikes

The mass shooting in Tucson on Jan. 8 that left six people dead and Rep. Gabrielle Giffords (D-Tucson) and 12 others wounded outside a Safeway grocery store dramatically demonstrated the responsiveness of our state’s emergency trauma system. The fact that Giffords and the other victims were transported within minutes to University Medical Center (UMC), one of Arizona’s eight Level I trauma centers, and other Tucson hospitals, is a testament to the importance and value of emergency preparedness.

UMC was well prepared to transition from a quiet Saturday morning with zero patients in its trauma center to a sudden influx of critically injured patients with life-threatening injuries. Open communication between first responders and the UMC trauma center was crucial and enabled the trauma team to mobilize prior to patients arriving by air and ground transport.

Thanks to effective interaction between the first responding law enforcement officers, EMS and trauma center staff, the gunshot victims were given high-level care at the scene and during transport. According to the Arizona Department of Health Services, traumatic injury is the leading cause of death for Arizonans ages one to 44. In 2009, Arizona’s Level I trauma centers treated 23,290 patients.

Arizona’s Level I trauma centers are located in Banner Good Samaritan Medical Center, Flagstaff Medical Center, John C. Lincoln North Mountain Hospital, Maricopa Medical Center, Phoenix Children’s Hospital, St. Joseph’s Hospital and Medical Center, Scottsdale Healthcare Osborn and UMC. All eight of Arizona’s designated Level I trauma centers are in populated areas, yet serve the entire state.

Medical experts often cite the importance of transporting victims of traumatic injury to a trauma center within the “golden hour,” or the first 60 minutes after an injury has been sustained, to improve their chances of survival. It is during this most critical time that a life can be saved if specialized medical care is administered.

Due to Arizona’s geographical expanse, trauma centers and first responders must work together to ensure quality care is available as quickly as possible for all residents. This does not happen by chance, and depends largely on the tremendous behind-the-scenes efforts involved in emergency preparedness planning meetings and training classes.

Level I trauma centers like UMC have earned their distinguished designation by meeting stringent requirements, including specialty physician staffing, clinical capabilities, as well as research and community education. Level I trauma centers are required to be staffed around the clock by surgeons, anesthesiologists, physician specialists and trauma nurses. Their commitment to caring extends well beyond the walls of their individual trauma centers to serve the entire state.

Laurie Liles is president and CEO of the Arizona Hospital and Healthcare
 Association, www.azhha.org.

Arizona Business Magazine Mar/Apr 2011

Health Care Leadership Awards 2011

HCLA 2011 – Behavioral Health Care Award

Richard Clarke, Ph.D., Chief Executive Officer, Magellan Health Services of ArizonaRichard Clarke, Ph.D., Chief Executive Officer, Magellan Health Services of Arizona

As CEO of Magellan Health Services of Arizona, Richard Clarke leads his team of 300 in implementing the Regional Behavioral Health Authority contract for Central Arizona. In so doing, Clarke is in charge of the strategic transformation of the system, quality outcomes for recipients, compliance, financial performance and Magellan’s relationships with the Arizona Department of Health Services, the Legislature and the community. His mission is to make Magellan a vehicle of change for the more than 80,000 care recipients who face life challenges due to mental illness and substance abuse, and are struggling to lead more productive lives in recovery.

Clarke chose to join the Magellan team as CEO in 2008. He launched a new system of open communication by instituting a volunteer governance board of recipients and community leaders that ensures transparency and focus in his company. He also led the expansion of the Crisis Intervention Team Training of 175 law enforcement officials, which has reduced intake time at the Urgent Psychiatric Center from two hours to 10 minutes.

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Medical Marijuana Where Will The Dispensaries Go

Arizona’s Medical Marijuana Proposition Passes, But Where Will The Dispensaries Go?

Arizona voters made history again this month, narrowly approving Proposition 203, the ballot initiative allowing one medical marijuana dispensary for every 10 pharmacies in the state (which translates to about 120 statewide). Under Prop. 203, patients suffering from a wide range of painful medical conditions will be able to buy small amounts of marijuana from state-approved dispensaries with a doctor’s prescription. Those living more than 25 miles from an outlet will be allowed to grow their own.

Needless to say, residents, cities and landlords are facing some interesting dilemmas before the first outlets potentially open in March 2011 … in a neighborhood near you.

Under the approved Prop. 203, the Arizona Department of Health Services must issue licenses to the so-called “medical marijuana clinics,” but it’s the local municipalities that must adopt zoning restrictions that regulate the size and location of such clinics. Cities are expressly forbidden under Prop. 203 from prohibiting them outright.

So who will ultimately win the “Not In My Back Yard” tug-of-war? Cities such as Phoenix, Tucson and Mesa, are grappling with commercial landlords, their constituents and zoning restrictions to keep the centers away from schools, churches and residential areas.

On the commercial real estate front, with the marketplace hard hit by the recession and Phoenix retail vacancy rates at 13 percent, many landlords are looking to fill empty space. But tenants such as medical marijuana clinics would cause some considerable controversy with residential neighbors and fellow commercial tenants.

“There are some landlords that will definitely have an issue with it,” said Pete Bolton, executive vice president and managing director of the commercial real estate brokerage firm Grubb & Ellis in Phoenix.

He expects dispensary operators to seek retail center locations with public exposure and easy parking. But, he added that some commercial landlords are hesitant to sign a marijuana outlet, especially if they have other tenants that cater to families or conservative customers.

Prior to the ballot passing, a number of nonprofit groups already were eying Phoenix-area shopping centers as possible dispensary locations. Even before the election earlier this month, more than 14 medical marijuana groups had reserved business names with the Arizona Corporation Commission. Some others were incorporating and looking for investors, dispensary locations and even growing sites.

Marketing manager for Medical Marijuana Dispensaries of Arizona Inc., Allan Sobol, says that like any other business, location is key.

“I want to be at a high-exposure location. I envision them just being like a CVS or Walgreens,” Sobol said.

He expects most marijuana outlets will be located in strip malls and other high-traffic locations near hospitals and medical centers. But with the dispensaries intermingled with other more conservative businesses, there could be some concerns.

So landlords will have some choices to make, and for Arizona cities facing these same dilemmas, the clock is ticking. Mesa, like Phoenix, will likely vote on where to locate the dispensaries by the end of the year.

This is likely the first time in history that a Mesa mayor has ever joked about collecting sales taxes on bongs or marijuana paraphernalia. But then, it’s probably also the first time in history that Mesa has come face-to-face with the prospect of stores legally selling marijuana. Given its size, Mesa could land between eight and 10 of the 120 dispensaries.

“This is not something we can prohibit,” Mesa Mayor Scott Smith said during a city council study session last month.

Under its proposed zoning regulations, Mesa would limit the dispensaries from residential, industrial and employment areas. Also, they could not locate within 2,400 feet of other medicinal marijuana shops and drug/alcohol rehab facilities. They would have to stay 1,200 feet away from churches, parks, open spaces in homeowner associations and libraries. They could be no closer than 500 feet from schools or group homes for the handicapped.

Arizona Department of Health Services Director Will Humble says cities need to act fast.

“Cities can’t wait,” he said. “If they don’t get it done in time, I’ve got no choice but to approve a dispensary if they don’t have a zoning restriction in place.”

In other words, the state bureaucrats will act if the mayors and councils haven’t.

So, while a razor thin majority celebrates the approval of Prop. 203, mayors and city councils around the state not only must act fast, but also wrestle with moral, political and economic issues before the first medical marijuana clinic opens on a corner — possibly in your neighborhood.

Voting Booth

Update: A Proposition Primer For Election Day – Tom’s Picks

Editor’s Note: With less than a week to go before Election Day, AZNow.Biz’s political columnist, Tom Milton, has revealed his recommendations on the 10 propositions on the ballot. As he says, “You’ll notice, I don’t like many of them.”

Election Day is almost here. If you are like me, you are probably already tired of the commercials, the phone calls and the mail.  Along with a sea of candidates on this ballot, we will also be asked to vote on a number of issues. There are 10 propositions on this November’s ballot. Understanding a proposition in itself can sometimes be tricky, but that is only half of the battle. The tougher part can be understanding what a “Yes” vote means as opposed to a “No” vote.  Here is a very short recap of the main points behind the 10 propositions.

I want to give special thanks to Stuart Goodman of Goodman Schwartz Public Affairs, who for the last few election cycles summarized this information so that it is easier to understand. I used his summary as my guide and added just a touch more information as well.

The first seven propositions are all items that the Legislature referred to the ballot.

Prop. 106 – Healthcare Freedom Act

Passing means that the state’s constitution would be amended to prohibit any law from forcing a person or business into having to participate in a specific health care system. It will allow a person to buy their health care from any provider without being fined or penalized.

Proponents (YES VOTE) say it will guarantee that health care consumers can make their own choices without being penalized.

Opponents (NO VOTE) argue it is just an effort to derail federal health care reform and will negatively impact the uninsured.

Tom’s Pick:

NO on Prop. 106
Behind every ballot initiative is usually a special interest or cause. This prop is meant to scuttle Obamacare. It is suppose to prevent people from being forced into a medical system that will penalize them if they don’t participate. It will actually not prevent Obamacare, but rather create conflict between the federal government and Arizona. I don’t feel this is the best way to deal with health care reform.


Prop. 107 – Arizona Civil Rights Initiative

Passing would amend Arizona’s constitution to ban affirmative action programs that give preferential treatment to any person or group on the basis of race, sex, color, ethnicity or national origin. This would mostly apply to government and political subdivisions such as school districts.

Proponents (YES VOTE) say this provides equal protection for all citizens by not providing preferential treatment to anyone.

Opponents (NO VOTE) argue this will turn back the clock on the civil rights movement, as these programs have helped level the playing field for disadvantaged groups.

Tom’s Pick:

NO on Prop. 107
I struggle with ballot initiatives that I feel are deceptively named. This ballot prop eliminates any affirmative-action style program. So why not call it that? Most civil rights advocates attribute affirmative action as a useful tool that has significantly helped in the civil rights movement. So this initiative wants to eliminate affirmative action and calls itself a “Civil Rights Initiative.” I know that not everyone likes these programs, but there are numerous U.S. Supreme Court decisions that prevent these programs from being run as quotas or set-asides. Any program implemented today has to be preceded by a disparity study showing that a statistical disparity exists. Then a program can be put in place for a limited time to correct that specific disparity. It is a tool. This initiative bans use of this tool and is deceptive in its name.


Prop. 109 – Right to Hunt and Fish Amendment

Passing means the Arizona constitution would be amended to declare that wildlife would be held in trust for Arizonans who have a right to lawfully hunt or fish. It would mean that only the Legislature could pass laws regulating hunting or fishing, and prohibits any law that unreasonably restricts hunting and fishing. It also provides that hunting and fishing are to be the preferred means of managing wildlife populations.

Proponents (YES VOTE) say this will protect hunting and fishing from future excessive regulation.

Opponents (NO VOTE) argue this will negatively impact the ability to use any other established wildlife management practices.

Tom’s Pick:

NO on Prop. 109
One of the things this initiative does is provide for hunting and fishing to be the preferred means of managing wildlife populations. Why would we chose to limit wildlife management to only hunting, when there are other scientific means that can also be useful? Big out-of-state money is being spent on both sides of this initiative. In favor of it is the National Rifle Association and opposed to it is the Humane Society.


Prop. 110 – State Trust Land Exchanges

Passing would amend the Arizona constitution to allow State Trust Land to be sold or leased without an auction if it is to protect a military installation or operation. It will also allow voters to approve land exchanges for military protection or land planning purposes.

Proponents (YES VOTE) say this will protect military facilities and helps better manage Trust Lands.

Opponents (NO VOTE), well, there aren’t any, or at least they haven’t said anything yet. I’ll keep listening.

Tom’s Pick:

YES on Prop. 110
When Arizona became a state, all of the land that the state owned was put into a trust to benefit education. Our forefathers were insightful to take the state’s largest resource and tie it to our greatest future need — education. It is protected in our constitution and has no flexibility. Unfortunately, there was no way that at statehood they could understand the idea of making small future exceptions that might serve a greater good. Protecting Luke Air Force Base is worth making an exception and adjusting the stringent constitutional land laws.


Prop. 111 – Lieutenant Governor

Passage would amend the Arizona constitution to change the title of the secretary of state to lieutenant governor. They would have the same job responsibilities, be elected independent of the governor, and be the first in the line of succession should the governor leave office.

Proponents (YES VOTE) say that given the regularity by which Arizona has had the secretary of state become governor, this would help voters understand the importance of the role when voting for them.

Opponents (NO VOTE) argue that after the primary election, same party candidates for governor and lieutenant governor would be forced to run as a slate. They also point out that this initiative calls for governor and lieutenant governor candidates to be from a major party, thus eliminating the ability of an Independent (which is not itself considered a party) to aspire to them.

Tom’s Pick:vote November 2, 2010

YES on Prop. 111
This initiative changes the title of the secretary of state to lieutenant governor. The person in office would still retain all of the same duties. Because Arizona has had a consistent history of governors not finishing their terms in office and the secretary of state taking over, this would help voters understand the significance of their vote: They are voting for the second-highest ranking official in the state.

Banner Baywood Medical Center

Arizona’s Health Care Providers Are Working To Eradicate On-Site Infections

Hospital-acquired infections — illnesses that attack patients after they have been admitted — have health care officials taking myriad steps to combat, control and prevent this insidious enemy.

One of those steps is a name change courtesy of the U.S. Department of Health and Human Services. They now are called healthcare-associated infections, or HAIs.

Jessica Rigler, HAI prevention coordinator at the Arizona Department of Health Services, explains the reasoning behind the terminology change: Health care infections occur not only in hospitals, but in all health care venues, including long-term care, assisted living, and urgent care centers. In addition, Rigler says, these infections are brought into a hospital by an ailing patient, and not necessarily acquired there.

Nevertheless, whatever term applies, HAIs present a serious challenge for hospitals in Arizona and throughout the country. In 2007, the Centers for Disease Control and Prevention estimated the number of HAIs in U.S. hospitals was 1.7 million, resulting in nearly 99,000 deaths each year.

In April 2008, Banner Baywood Medical Center in Mesa was thrust into the spotlight following an HAI outbreak. The staff launched an aggressive program to deal with the situation, such as correcting air-pressure problems in some of the 10 operating rooms, and firing an overnight cleaning crew that was found to have missed germs on operating room floors, equipment and operating tables.

The hospital also limited the number of students and observers allowed in operating rooms, switched to thicker surgical wrap, and directed surgeons to wear only hospital-laundered scrubs.

Seven months after numerous changes were implemented, Banner Baywood, a general, acute-care hospital that performs about 10,000 surgeries each year and serves many senior citizens, detected just one surgical-site infection, according to Chris Halowell, director of perioperative services at the hospital.

Arlene Gimbel, chief nursing officer at Banner Baywood, says some infections are the direct result of overuse of antibiotics.

“We have dealt with this for quite some time, and we will continue to do so,” she says. “Our rate (of infection) has improved over the last couple of years due to our infection prevention program.”

While the hospital’s goal is to have zero infections, Gimbel says, “It’s almost impossible to be at zero, but it’s something we strive for every day. An area we can control is personal hygiene.”

A key element in preventing the spread of HAIs is to identify patients with an infection upon admission and take appropriate precautionary measures, Gimbel says. Every single patient found to have an infection was treated successfully, she adds.

Rigler says the problem is not as serious as it was some months ago because of infection prevention and control measures taken by health care facilities. Each hospital tracks its own data, but Arizona does not require public disclosure of infections that occur in health care facilities.

“We’re continually moving in the direction of preventing infections,” she says.

Early this year, ADHS established a new healthcare-associated infection advisory committee to follow up on recommendations of a legislatively created HAI panel in 2008. The original committee issued a report last December concluding that “strategies other than public reporting would be more successful in preventing healthcare-associated infections,” Rigler says. Four subcommittees, which Rigler calls the workhorses, focus on prevention strategies, surveillance, public education and provider education.

“The prevention strategies subcommittee is working to synthesize HAI prevention, gather the best practices and guidelines recommended from institutions nationally, and pull together a tool kit of information to help health care organizations decide on costs, how to implement programs, and how sustainable interventions are going to be,” Rigler says.

The surveillance panel is exploring how health care facilities are monitoring infections, what data they are collecting, and will then work closely with the National Healthcare Safety Network, which is run by the CDC.

Regarding the need for more transparency, Rigler says ADHS has an excellent relationship with its partners throughout the state. If ADHS notices an increase in infections, it contacts local health agencies, which then provide expertise and assistance.

“We have an obligation not to disclose certain pieces of information about one’s health condition,” Gimbel says. “It’s true that the public has a right to know, but one of the reasons health care facilities are reluctant is because of our responsibility toward patient privacy.”

To provide guidelines for other hospitals facing an outbreak of infections, Banner Baywood published an extensive article on its outbreak and plan of action in the March 2010 issue of AORN, a publication of the Association of periOperative Registered Nurses.

“We wanted to share our experience with the rest of the community,” Halowell says. “We included a timeline of what we did. They can use that as a check list if they have an outbreak. We’re proud of our infection prevent program and feel very good about our patients being safe when they come to Baywood.”

Good Samaritan Hospital at sunset

Massive Budget Cuts Have Arizona’s Hospitals And Health Care Industry Closing Ranks

As bad as 2009 was, the health care industry in Arizona is still bracing for the worst. So says John R. Rivers, president and chief executive officer of the Arizona Hospital and Healthcare Association (AzHHA), whose organization, along with others, lobbied unsuccessfully against massive legislative reductions totaling $2.7 billion to the Arizona Health Care Cost Containment System (AHCCCS) and Arizona Department of Health Services’ budgets for fiscal 2011.

The cuts were part of an effort by the Legislature to dig the state out of the deficit hole it finds itself in.

“I can’t predict who is going to do what in response to these cutbacks, but I can tell you that every person in Arizona will be affected by these cuts in some negative manner — either though higher insurance premiums, more overcrowding in hospital emergency rooms, reduced services provided by hospitals or even some hospital closures,” Rivers says. “The impact of these cuts will be far-reaching and long-lasting.”

Hospitals alone stand to lose $1.15 billion in the fiscal year that starts July 1.

“Our focus and energies must be on the daunting challenge of dealing with the negative impact on patient care as a result of the budget cuts recently enacted in Arizona,” says Peter Fine, president and CEO of Banner Health. “These cuts will result in reductions of $2.7 billion in health care spending, including scheduled cuts of more than $1 billion to Arizona hospitals in 2011. This will place tremendous pressure on the state’s hospitals.”

The AzHHA position is that the budget cuts not only will devastate Arizona’s health care community, but also cripple the state’s economy. Arizona’s hospital community employs approximately 73,000 people and contributes $11.5 billion to the state’s gross product. In a recent report, the Seidman Research Institute at the W.P. Carey School of Business at Arizona State University estimated the budget cuts would result in a loss of 42,000 jobs across virtually every segment of the Arizona economy.

Those job losses, Rivers says, “will worsen Arizona’s economic downturn and flies in the face of legislators’ efforts to create new jobs and revitalize the state’s business climate.”

The health care sector would suffer the greatest loss of jobs, totaling an estimated 19,600 in 2011. Employment losses also would hit such categories as arts and entertainment, construction, finance, manufacturing, mining, real estate, retail, transportation and warehousing, according to the ASU report.

Other startling numbers from the report indicate that real disposable income would be reduced by $1.74 billion — approximately $200 per capita — and the state’s population would shrink by 10,000.

Even before the Legislature took final action, St. Joseph’s Hospital & Medical Center already was dealing with the state’s budget implosion.

“Because we are the largest hospital in Arizona, and treat more AHCCCS patients than any other private hospital, these cuts have been devastating to us,” says Linda Hunt, service area president of Catholic Healthcare West (CHW) Arizona and president of St. Joseph’s. “The Legislature cut more than $14 million in funding to our hospital alone between mid-December and February. Part of these cuts wiped out funding for our graduate medical education program, which trains more than 200 medical residents in 10 different clinical specialties. We now have to make up the deficit. In addition, our charity care costs continue to increase, we are seeing more uninsured patients in our ER, and we are seeing more mentally ill patients in the ER because they have nowhere else to get help.”

Hunt’s concern for the most vulnerable members of society is echoed by Betsey Bayless, president and CEO of Maricopa Integrated Health System (MIHS), which operates the Maricopa Medical Center.

“About 65 percent of our patients are on AHCCCS, and we operate the Valley’s largest psychiatric inpatient hospital, Desert Vista, in Mesa,” Bayless says. “Furthermore, patients without coverage will seek care only when their conditions worsen, thus driving up emergency room demand — the most costly means of caring for illness and disease.”

Further putting a human face on the budget cuts, health care coverage is being eliminated for 310,500 low-income adults and 47,000 children, and mental health treatment ends for 36,500 adults and children.

Hospital officials fear their emergency rooms will be inundated by additional waves of the uninsured. Emergency rooms are federally mandated to screen and stabilize all patients, without regard to their ability to pay for care. In 2008, Arizona hospitals provided approximately $392 million in uncompensated care to uninsured patients. Hospitals make up the loss by absorbing or shifting costs to commercial health plans, which then charge businesses and individuals higher health insurance premiums, AzHHA maintains. The cost-shift, coupled with further cuts in AHCCCS hospital payment rates, amounts to a hidden tax on health care consumers, according to AzHHA.

The budget cuts also eliminate the KidsCare Program, which provides medical services and preventive health care for children of families who cannot afford insurance. Ending the program saves the state $22.9 million, but costs the state $95.5 million in federal matching funds, for a total loss of $119 million to the state’s health care system. Hospitals will lose $44 million in revenue, AzHHA says.

Of extreme concern to the medical community is a measure on the November ballot that targets Proposition 204, which was approved by voters in 2000. Prop. 204 expanded eligibility for AHCCCS, but the new ballot measure asks voters to deny eligibility to an estimated 315,000 individuals who benefited from the 2000 proposition. Under the ballot proposal this year, the state would save $765 million, but would lose $1.5 billion in federal matching funds, for a total reduction of $2.3 billion to the Arizona health care community. Hospitals alone would lose an estimated $851 million in revenue.

To cope with reduced funding, MIHS has limited new hires and is formulating plans to address these unprecedented budget cuts.

“Moreover,” Bayless says, “we recognize this is not our problem alone. Rather this is a community-wide issue, and I have been reaching out to other health care leaders about ways we can work together to best care for our Valley residents.”

Hunt says St. Joseph’s employees have provided dozens of ideas on how the hospital can operate more efficiently, while preserving patient safety and quality care.

“We are looking at a wide variety of community, academic and business partnerships, and are re-evaluating our strategic plan to add more focus on the service lines that are most needed in the region,” Hunt says. “We are a ‘destination hospital’ for many complex illnesses and will continue to bring patients in from around the country and around the world. We will also advocate strongly for the state to provide services for the most needy and encourage our leaders to see health care as a vital contributor to the state’s economic recovery.”

As for its next step, Rivers says AzHHA will work to guard the funds that escaped the budget axe.

“We will develop a proposal that protects these health care programs either through new revenue sources or requiring that existing revenue sources earmarked for these programs are used for their intended purposes — not just dropped into a black hole in the general fund,” he says.

2010 Health Care Leadership Awards

2010 HCLA – Legislative Impact Award And Lifetime Achievement In Research Award

Legislative Impact Award

Honoree: Roy Ryals, Executive Director, Southwest Ambulance

Roy Ryals
Executive Director
Southwest Ambulance

Virtually every pre-hospital care related rule at the Arizona Department of Health Services, and every piece of related state legislation approved in the past 30 years, has something in common — Roy Ryals helped to write it.

Roy Ryals, Executive Director of Southwest Ambulance, 2010 Health Care Leadership Awards

Ryals, executive director for the Southwest region of Southwest Ambulance and Rural/Metro, is considered the pre-hospital regulatory expert and reference point. His knowledge and memory of the history behind decisions, and the far-reaching effects of every word that’s written, has earned him the respect of both the industry and state regulators.

In effect, every patient in Arizona who has used an ambulance over the past 30 years has benefited from Ryals’ intellect and participation in the legislative and regulatory process, whether he’s at the state Capitol, in a board room, or in the back of an ambulance. Ryals has been appointed by four Arizona governors to the Emergency Medical Services Council and was named by three directors of Department of Health Services to the State Trauma Advisory Board.

He is president of the Arizona Ambulance Association and a registered lobbyist with the state. At Southwest Ambulance and Rural/Metro, Ryals is responsible for all contracts, regulatory issues and legislative oversight. He indirectly oversees all field employees through his involvement in medical protocols and regulation for field crews of both companies. He also manages Southwest’s administrative leadership team and legislative consultants. Ryals began his career at Southwest Ambulance in 1987 as the executive director over Arizona medical transport.

Two years later, he was promoted to national director of EMS. In 1991, he became the regional chief operating officer overseeing system integration and regulatory compliance.

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Lifetime Achievement Award

Honoree: Joseph Rodgers, PH.D.

Joseph Rodgers, PH.D., Founder and Senior Scientist
Banner Sun Health Research Institute

Joseph Rogers, Ph.D., the motivating force behind Banner Sun Health Research Institute in Sun City, has devoted three decades to finding the cause of and cure for Alzheimer’s disease. But the first work from researchers at the institute did not originate in multimillion-dollar labs or in high-tech facilities; they began their research at a card table with folding chairs.

Joseph Rodgers, Founder and Senior Scientist Banner Sun Health Research Institute, 2010 Health Care Leadership Awards

The institute, a tribute to Rogers’ tireless efforts in the field of Alzheimer’s research, has created opportunities for intensive research into other age-related illnesses, including Parkinson’s disease and arthritis. The discoveries already made at the institute, and those yet to come, promise to have significant benefits for millions around the world. Rogers, the institute’s founder and senior scientist, was recruited in 1986 to develop the research facility.

His qualifications for this breakthrough role include a doctorate from the University of California, San Diego; a postdoctoral fellowship and service as a staff scientist at the Salk Institute; and immediately prior to his arrival in Arizona, he was at the University of Massachusetts Medical School, serving as a principal investigator within the New England Alzheimer’s Disease Center at Harvard University. Rogers made the revolutionary discovery of the damage that inflammation causes to the Alzheimer’s-affected brain. Initially, other scientists scoffed because conventional wisdom precluded the inflammatory process from entering the brain, but Rogers’ discovery changed Alzheimer’s research.

Under Rogers’ leadership, the institute has attracted internationally recognized faculty and scientists, who have made their own compelling discoveries, including a direct linkage between Alzheimer’s and high cholesterol, and a compound of drugs that has promise for significant benefit to those with rheumatoid arthritis. Another key to the institute’s growth is its full-tissue repository, which Rogers initially developed as a brain bank soon after founding the institute.

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