Overcoming obstacles

2 0 1 2 A n n u A l R e p o R t

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MIl eS t o n eS

C R E A T I N G P A R T N E R S H I P S • I N S P I R I N G H O P E • C H A N G I N G L I V E S

Our core values

Be innovative

Use creativity and ingenuity to reveal resources,

nurture strengths, find answers and provide solutions

Collaborate

Galvanize each other, the people we serve, and the

community to work together to improve peoples’ lives

and the behavioral health care system

take action

Deliver and expect nothing less than impassioned

and unwavering dedication to helping people realize

independence, be more resilient, achieve recovery,

and have purpose and meaning in their lives

Be strong

Search out strengths and abilities in yourself and in

those around you, and share the strength and passion

of our organization in every word and deed

Changes to AhCCCS eligibility requirements also wentinto effect in October 2011, making it more difficult forsome of the people we serve to maintain their benefits.

yet, as you’ll see in the pages of this 2012 Annual Report, we continued to reach higher, dig deeper, and stretch farther to do what we’ve always done: Whatever is neededfor the people we serve.

In fiscal year 2012, we provided behavioral health servicesto 19,213 youth and 7,696 adults, along with compassionatesupport to their families and caregivers. We continually didour best to enhance peoples’ access to care, engage them inservices, and improve the quality of care we provide.

We remain the largest provider network organization inMaricopa County, Arizona and one of the largest commu-nity behavioral health care providers in the united States.

Southwest Network provides behavioral health services

to infants, children, adolescents and adults, partnering

with them, their families and caregivers to help them

overcome the obstacles they face to live their best lives.

In fiscal year 2012 (July 1, 2011 through June 30, 2012),Southwest network faced obstacles of its own. It was thesecond year of reduced funding from the state, cuts toprovider rates and other budget pressures. ere were manychallenges to maintaining services and programs for thosewe serve, even while continuing economic pressures made itmore difficult than ever for them to find jobs, homes, andthe assistance they needed.

A further challenge was presented when enrollment in theArizona health Care Cost Containment System (AhCCCS,Arizona’s Medicaid system) for childless adults was frozenthroughout the year in an effort to balance the state budget.under the freeze, no new applicants were accepted andthose who dropped off the rolls for any reason were not allowed back on.

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Overcoming obstacles together oveRvIew o f f Y 2 01 2July 1, 2011 thrOugh June 30, 2012

Clinics providing adult services ........................7

Sites providing child and adolescent services ......3

Co-locations with Arizona Child Protective Services ..4

Co-location with a federally qualified

health care provider ..........................................1

Adults served..........................................7,696

Children and adolescents served ..............19,213

Adult services staff members ........................350

Child and adolescent services staff members ....168

Administrative headquarters staff members ......36

Total staff members ....................................554

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My daughter has a serious and chronic mental

health disorder. She has been hospitalized

three times in the last year. I had a previous

case manager with whom I had almost no

contact and no help. I thought that was just

the way it was and I was simply astounded at

the difference when Southwest Network took

our case. Our case manager initiated frequent

meetings ... to determine appropriate goals

for my daughter and developed the treatment

plans to help achieve those goals. She has

immeasurably improved my daughter’s life.

—LINDa C., MD, MPH

Youth are tough and resilient. But when they have mental

health or behavioral issues, they need help to remain

determined, stay strong, and beat the odds.

to serve them, Southwest network uses the nationally recognized Child and Family team process, which com-bines individualized planning with youths’ natural supportsystems. We listen, solve challenges, and support familiesthrough the process of helping youths stay in their homes,be productive in school, and become independent adults.

A System of Care Practice review by the Arizona Depart-ment of health Services verified that our case managersconsistently demonstrate a good understanding of families’culture, values and beliefs. reviewers also noted that theneeds of the child and family are identified and prioritizedacross a full range of life domains.

Comprehensive services and supports provided throughout2012 demonstrated a high level of commitment to qualityservice:

In-house counseling services were added to make accessto services more convenient and to provide expertise andconsultation to child and family teams. two offices wereremodeled to provide expanded family counseling areas.

We continued to be recognized as experts in services forinfants and toddlers age birth to 5, providing servicesthroughout the community.

Our transition to Independence Process program provided specific tools to help young adults ages 16 to 22realize their potential and goals for self sufficiency, in-cluding specific services in the areas of employment,housing, education, and social interactions.

Members of the youth Advisory Board—young adultsages 15 to 22—used their past experiences with the behav-ioral health system to advocate for change and educateothers. ey also worked to improve their communitythrough active involvement in service projects.

Our CAFe program—Communities and Families en-gaged—held regular education and social events to helpconnect families and parents/caregivers to others and involve them in the community.

Our community based care team provided specific ex-pertise to limit out-of-home placements and keep morekids in their homes or with family members, or ensurekids are returned to their homes and families as quicklyas possible when out-of-home placement is necessary.

Family support partners and parent partners with life experience in the behavioral health system assisted recipi-ents with skill building, problem solving, and accessingresources, as well as with processes and communications.

Our electronic medical records system was certified formeaningful use.

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SeRvIC eS fo R Yo u t H

Case management

Birth to five intervention

Transition to independence program

Parent and family support

Rehabilitation and support

Psychiatric evaluations

Substance abuse evaluations

Specialized assessments

Counseling and therapy

Medication

Crisis intervention

Transportation assistance

helping infants, childrenand adolescents stay strong

CHIlDRen AnD ADoleSCentS SeRveD

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

3,000 6,000 9,000 12,000 15,000 18,000

During the time our team has been lead by a Southwest Network case manager, we have expe-

rienced the good fortune of someone who not only understands how to do their job, but actually

does it. Now we can accomplish what we’ve been asking for: diagnosis and reunification.

—MICHaeL S.

1,910

2,865

3,773

5,020

7,225

7,895

7,946

7,268

8,300

14,489

16,903

18,935

19,213

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I want to express my appreciation to you

all for the work you have done involving

my son. This has been a difficult year for

[him] ... he has offered you many opportu-

nities to go the extra mile and you have.

From the courtesy of the receptionist to

the patience of the physician, the focus

has been on helping my son to overcome

his multiple obstacles. There were times

when I could not see any solutions and my

‘empty cup’ was refilled when I observed

the professionalism, caring and respect

that was shown to me and my son.

—SHaRON M.

In this fast-moving, ever-changing world, adults with serious

mental illness must dig deep and push hard to overcome

their challenges and keep moving on their road to recovery.

rough a combined focus on mental health, physicalhealth, community integration and employment, we helpseriously mentally ill adults understand that they can getbetter and help them attain their goals for recovery. esegoals are not different from what everyone wants, but morechallenging to achieve with serious mental illness.

In our continuing drive to help people obtain and maintainemployment or involvement in meaningful community activity, we hire service recipients through our own tran-sitional employment program to give them real-life work experience. We also maintain extensive resources on our Intranet site for staff members to use in assisting service recipients in obtaining employment.

A focus in 2012 was on recognizing suicide ideation andpreventing suicides. Our Saguaro adult clinic took part inthe “Driving Suicides to Zero” pilot program of Magellanhealth Services of Arizona—the regional behavioral healthauthority—which used new tools to screen and assess thosewho need targeted suicide intervention. e program isnow being implemented at all of our adult clinics.

to further advance suicide awareness and prevention, wecontinue to provide the financing and resources necessaryto give all clinical staff members Advanced Suicide Inter-vention Skills training. Our morbidity and mortality com-mittee continues their careful review of all deaths to ensurewe are doing everything we can to prevent deaths by suicideand other non-natural causes. Plus we actively participateon Magellan’s suicide prevention steering committee.

Other outstanding programs and services which helped service recipients achieve their goals for recovery in 2012included:

Proactively ensuring service recipients maintained AhCCCS (Medicaid) coverage or other benefits to what-ever extent possible so they could continue receiving theservices they need.

Working to increase attendance at Clinic Advisory Coun-cils so recipients and their families may participate inthese forums for communication and involvement in theclinics where they receive services.

Putting specially trained case managers in place to provide specific assistance to 18- to 25-year-olds transi-tioning from the child and adolescent system of care tothe adult system of care, helping them with education,employment, housing, and social interactions.

Completely remodeling two clinics to be more open andwelcoming and moving a clinic from its outdated building.

helping adults win in life

SeRvIC eS fo R AD u lt S

Case management

Crisis intervention

Psychiatric evaluations

Substance abuse evaluations

Medication

Nursing

Rehabilitation and support

Employment rehabilitation/training

Peer and family support

Housing support

Transportation assistance

Your attitude toward the mentally ill has, I can say from experience, contributed to the overall

improvement of your mentally ill clients. Thank you from the bottom of my heart for making

me feel valued, important, and most importantly, as a human being.

—RaBIaH S.

all Southwest Network sites have been

approved as National Health Service Corps

(NHSC) sites. This network of partners

is dedicated to providing care in com-

munities with limited access to health

care. NHSC membership increases our

ability to attract and retain high quality

medical professionals.

nhSC approved

A P P R O V E D S I T E

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ADultS SeRveD

2009

2010

2011

2012

3,000 6,000 9,000

7,191

7,972

7,720

7,696

exeC u t Ive MAn Ag eMen t

Amy B. Henning, Chief Executive Officer

Kent Eller, MD, Chief Medical Officer

Michelle Fornoff, Chief Financial Officer

Anita Barnas, Vice President, Clinical Operations

Robert Sanowski, Chief Information Officer

Lisa Elowson, Vice President, Human Resources

B oAR D o f D IR eC t o R S

Steve Carter, NOVA

Fred Chaffee and Michael Coughlin,

Arizona’s Children Association

Timothy Dunst, Touchstone Behavioral Health

Jeff Jorde, Southwest Behavioral Health Services (Chair)

Mitch Klein, CHEEERS Center (Secretary)

Sara Marriott, PSA Behavioral Health

Ann Rider, Recovery Empowerment Network

Phil Sawyer, Recipient

Frank Scarpati, Community Bridges

Shirley Suzor, Phoenix Interfaith Counseling

Helga Wilson, Family Member

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Front row, L to R: Lisa Elowson, Amy B. Henning, Anita Barnas. Back row: Michelle Fornoff, Dr. Kent Eller, Bob Sanowski

In fiscal year 2012, the position of chief medical officer was created and accepted by Dr. Eller, former medical director for

adult services. He will direct the integration of medical and behavioral health services for all service recipients. Anita Barnas

was promoted from vice president of adult services to vice president of clinical operations and now directs both the adult

services division and the child and adolescent services division.

It takes a team of dedicated and special people to help

others conquer adversity, accomplish new skills, and

aspire to greater heights.

From our organization’s executive management team, to siteleaders, to frontline staff, to administrative support staff andproviders, we expect high performance and quality service.Poor performance at the risk of any service recipient’s out-come is not acceptable to any one of us.

Our expectations are met on a daily basis with unwaveringdedication and commitment. Our staff members and lead-ers are professional and knowledgeable, and they caredeeply about those they serve.

ey are also caring and giving members of the communityin which they live. ey turn out in droves for the annualnAMI Valley Walk to raise funds for the national Allianceon Mental Illness (nAMI). In 2011 and 2012, the Southwestnetwork team broke national records for the highest num-ber of walkers on one team.

Our employees also hold fundraisers, food drives, schoolsupply drives, and host holiday meals on their own time.

Members of our exceptional medical staff provide trainingfor medical students and psychiatric residents. We provideour medical staff with educational opportunities such ascontinuing education and ground rounds—including apresentation from Dr. lois Choi-Kain of harvard in 2012—and leadership training from the American College ofPhysician executives.

to ensure all staff members have the tools and training todo their work effectively, we have extensive in-house sup-port departments in quality assurance, human resources,training, information technology, risk management, com-munications, and accounting. A world-class Intranet site is constantly updated with the information, tools and resources they need to not only provide excellent service,but to make the most of their employment experience.

We are committed to keeping up with their technologicalneeds, as well. We provide laptops, cell phones, and otherequipment as needed, and in 2012, outdated computerswere replaced and old-style Crt monitors were updatedwith flat-screen monitors.

We also try to ensure their personal needs are met. In 2012,we focused on their wellness by sponsoring a walking pro-gram. We also introduced a new health insurance programthat included lower-cost options.

to recognize their commitment and dedication, welaunched an anniversary program that recognizes milestoneanniversaries with gis and luncheons. And we always tryto make sure they have fun with an annual company picnic,holiday meals, and other events throughout the year.

We are proud of each of our employees.

A New Leaf, Inc.

Aid to Adoption of Special Kids AZ

Arizona Youth & Family Services, Inc.

Arizona’s Children Association

Michael B. Bayless and Associates, Inc.

dba Bayless Behavioral Health Solutions

Black Family & Child Services, Inc.

Chicanos Por La Causa, Inc.

Child Crisis Center, Inc.

Child and Family Support Services, Inc.

Childhelp Children’s Center of Arizona

ComTrans, Inc.

Counseling & Consulting Services

Devereux Arizona

Family Involvement Center

Florence Crittenton Services of Arizona

Mentally Ill Kids in Distress (MIKID)

Native American Connections, Inc.

Nicole Roskens

Phoenix Interfaith Counseling

PSA Behavioral Health Agency

Rio Salado Behavioral Health Systems, Inc.

Southwest Behavioral Health Services, Inc.

Southwest Human Development, Inc.

The New Foundation

The Resolution Group, Inc.

Total Transit, Inc.

Touchstone Behavioral Health

Youth Evaluation and Treatment Centers, Inc.

Youth Advocate Programs, Inc.

Zarephath, Inc. – 9 –

Working together to win

StAff MeMBeRS

Prior to 2006, the average number of employees per year was less than 42.

2006

2007

2008

2009

2010

2011

2012

100 200 300 400 500 600

Southwest network carefully selects and over-sees the following qualified service and directsupport providers who partner with us to provide contracted outpatient services for children and adolescents:

pRovID eR S

42

73

331

608

587

553

554

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SeRvIC e u t Il IZ At Io n : AD u lt SeRvIC eS

SeRvIC e u t Il IZ At Io n :C H Il D An D AD o l eSC en t SeRvIC eS

Fiscal year 2012 Financials

H IS t o R ICAl R even u e

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

expen SeS

e increase in revenue over the years reflects a growth in community need and an expansion of our organization

Operating Supplies and expenses 0.7%

Office expense 1.1%

Other 1.6%

Travel and Transportation 1.8%

Occupancy 3.0%

Professional andOutside Services 12.6%

Salaries and Benefits 40.9%

Contracted ChildOutpatient Services 38.3%

REVENUE IN MILLIONS $10 $20 $30 $40 $50 $60 $70 $80

$ 5.42

13.84

21.43

20.97

22.89

25.96

21.86

33.39

59.34

85.00

82.08

82.57

Day Program 1.1%

Interpretive Services 3.2%

Medical Services 3.9%

Transportation 4.7%

Treatment 26.3%

Rehabilitation andSupport Services 24.3%

Case Management 35.8%Flex Funds 0.5%

Peer Support 2.0%

Transportation 2.3%

Rehabilitation andSupport Services 2.9%

Treatment 4.9%

Medical Services 17.5%

Case Management 69.4%

Interpretive Services 0.7%

Peer Support .2%

Flex Funds 0.3%

Included are administrative costs and expenses for all service programsand payments to contracted service providers for adult services andchild and adolescent services

With the introduction of the federal affordable Care act,

“integrated health care” has become a common catch

phrase. at Southwest Network, it is more than just talk.

We are taking the lead in integrating physical health care

into the behavioral health services we already provide and

improving the health and wellness of those we serve.

Southwest network is partnering with both Magellan andMaricopa Integrated health System to provide integratedhealth care to those we serve. In May 2012, our first inte-grated health home opened at our San tan adult clinic. Our second integrated health home will open in early 2013.

In child and adolescent services, our Mountain Park healthCenter co-location celebrated its two-year anniversary of pro-viding integrated care in July 2012. together with the medicalpractitioners at this federally qualified health care center, wemeet both physical and behavioral health needs of childrenage birth to 8 years in a high-needs area of Phoenix.

For the people we serve, recognition of symptoms, diagnos-tic assessment, development of a treatment plan, and carefulmonitoring and follow-up care for both physical and behav-ioral health issues—with a focus on the whole person—willbe a key part of health care reform and will mean a higherquality of care and improved outcomes.

In addition to providing integrated care, we focused on theoverall health and wellness of service recipients in 2012through multiple avenues:

A health risk assessment tool was put in use to ask targeted questions about service recipients’ physicalhealth— including gathering data on personal and familyhealth histories—to help determine their risk for chronic conditions and guide integrated health planning.

We utilized a $750,000 community reinvestment grantfrom Magellan to expand integrated health services byhiring a healthcare coordinator and peer health coaches,create educational materials, and provide incentives andgroups to improve overall health and wellness.

Medical staff at six of seven adult clinics were licensed to pro-vide Suboxone (buprenorphine) induction and stabilizationfor the treatment of opiate addiction and dependency underthe direction of a new director of addiction medicine.

televisions were placed in the lobbies of adult clinics tocarry educational programming on a variety of healthand wellness topics.

Our smoking cessation program continued in collabora-tion with the Arizona Smokers’ helpline (AShline.org).

A health awareness campaign that began in 2010 contin-ued to use informational flyers and posters to educate recipients and staff alike about common health issues.

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I would like to tell you about (a service recipient) who was referred by his very diligent—and understandably concerned—case manager who had been concerned

for several weeks about a shoulder injury he had suffered during a biking accident weeks earlier. He will likely need therapy and possible surgery as well as

close follow up, but I am confident that, with the great help of his psychiatric team, we will be able to address all of his health needs.

--SHILOH D., N.P., MaRICOPa INTeGRaTeD HeaLTH SYSTeM

Integrating physical and behavioral health for overall wellness

Southwest Network’s San Tan Integrated Health Home

opened in May 2012. The San Tan site has been rec-

ognized by the regional behavioral health authority as

one of the top five adult clinics based on outcomes.

www.SouthwestNetwork.org | info@SouthwestNetwork.org

2700 North Central ave., Suite 1050 | Phoenix, aZ 85004

Phone 602.266.8402 | FaX 602.264.0887

reaching new heights

A P P R O V E D S I T E