A ghost in the machine

Flashback to 2013 Some details may be left out to avoid any breach of client confidentiality In a nod to a local policy requiring profanity to be documented by partly spelling certain words with asterisks, that's what I'll be doing here. It's time for the weekly meeting at the group home. The boys who are made to live here are elsewhere for the duration of the staff meeting. Outside, the temperature is hot, as is normal for summer. Inside, the house is dim, cool, and almost damp-feeling. Several of the staff members, and the middle manager who oversees the site, are vaping inside the house. This is probably in violation of company policy, but the middle manager (henceforth called coordinator) tends to violate company policy and sometimes several state laws. He is very overweight, which will in the future contribute to him suffering from deep vein and pulmonary thrombosis, but for now he uses his bulk and his personality to look intimidating. His vape pen is tipped with...

The changes in the local behavioral health system were effective yesterday, October 1. Pay cuts were announced for BHMP staff (psychiatrists, psychiatric nurse practitioners, physician assistants) at one local clinic. Some of them walked out after hearing this. Some people might say so what, they make a lot of money, but the fact is their schedules are jam-packed all day long and they are under pressure to "produce" (bill as much as possible). They pretty much have earned every penny. Layoffs have started. Positions are simply eliminated. Just recently the agencies were hiring for staff like recovery coaches or peer support specialists. Now their job postings have mostly evaporated. It will be interesting to see how things go in the next month.

I once attended a job fair being held by a local behavioral health agency. They were hiring for a variety of positions. Besides me, there were several people from other local agencies seeking to get hired there. I had seen or met these people in the past--at trainings, or other functions. These people were experienced and knew the system, and would have likely provided good services to clients. When I had my brief interview, the two people conducting it seemed to be doing it simply as a courtesy since I had shown up and met at least the minimum qualifications (in this case, have a pulse and a bachelor's degree in a related field). They went through the list of questions and overall it was pretty quick. At the end of the interview, they were courteous but let me know that this agency was really seeking people just out of college and saw the case management position as entry level. Sure enough, during my wait for the interview, there had been a young-looking person who was being gi...

Been busier lately. Hiring taking place some places for case management staff, for general mental health and substance abuse caseloads. The question that is unanswered is what will happen with these positions come October. On October 1, the AHCCCS health plans will take over case management directly for general mental health and substance abuse clients, while SMI clients remain with the RBHA and the contracted agencies such as COPE, CODAC, La Frontera, and so on. This is less than a month away.

Community Partners is merging with Intermountain Centers for Human Development. According to the press release, Intermountain will be the sole partner in the new venture. Community Partners Inc. used to be known as Community Partnership of Southern Arizona (CPSA). It was the previous regional behavioral health authority (RBHA) for Pima County. It managed to transition to being another agency like COPE , CODAC , La Frontera , and the like, and managed to go on for almost 3 years before this merger. In that time, it managed to take over Assurance Health and Wellness, and was able to outlast Pasadera . They owned a large facility on Dodge Blvd just north of Grant Rd, which provides space for a residential treatment center (not run by CPI), a brief intervention placement program (run by CPI), as well as providing conference space for other organizations with catering. Those of us who have been around for a while may remember the coffee and scones provided at trainings during the CPSA ye...

The state of Arizona has a site where you can look up some records on places like residential programs, clinics, hospitals--basically, settings licensed by the Arizona Department of Health Services. This is a resource available for the public. This does not include places that are no longer in operation. It also does not include child foster care homes (for very good reasons). But if you are curious, or would definitely like to see information about a current program listed there, here's a link: https://azdhs.gov/licensing/index.php To be honest, some of the information contained can be pretty boring. Some places seem to operate without a lot of problems showing when inspected. Some may have citations over what seem to be really small things that are otherwise legally required. However, some of it can be pretty alarming, such as finding a citation that a group home staff member punched a minor client, or that a group home had poor or filthy conditions. Some companies seem to h...