• Danny Valenzuela, deputy director, administration
• Leslie Schwalbe, deputy director, behavioral health
• Rose Conner, assistant director, public health
• Mary Wiley, assistant director, licensing.
• Pat Mah, budget director
• Mike Fronske and Liana Martin, legislative affairs

Everyone here stands ready to answer questions after my presentation.

We play such an important role in promoting health, preventing disease, and protecting the public – yet many people still don’t even know who we are…

In fact, I’ve always thought a great final jeopardy clue might be:

“A profession people cannot begin to explain.”

The answer: “What is a public health epidemiologist?”

Let me start by telling you that we perform three basic functions at the department of health services.

We do three things: mental health, licensing and public health.

We have a budget of more than $1 billion, and about 1,800 employees.

In behavioral health, we serve more than 130,000 people across Arizona through five Regional Behavioral Health Authorities and three tribal health authorities.

I know many of you have read about 
Arnold vs. Sarn, a 25-year-old class action lawsuit I inherited as Director.

Today, I’m happy to report that we’re taking some very bold steps toward bringing closure to this lawsuit. 

This has occurred through an unprecedented collaboration among consumers, providers, and advocates – under the leadership of Leslie Schwalbe.

Together, we have worked tirelessly to shape a reform plan that focuses on recovery-based treatment.

In December, a Superior Court judge accepted the agreement – and I’m happy to say we’re already seeing results.

For the first time in 25 years, we have a plan to exit this lawsuit … and I am very excited about the possibility of bringing this case to a close.

Let me tell you one story that shows how we are making a difference.

One Maricopa County consumer, whose name is Anna, had hit rock bottom.

She had been living in a halfway house, working though her behavioral health problems.

Her goal was simple – to get her children back – but her living situation made that impossible.

A Value Options case manager referred Anna to a community-building program, and her life began to change.

She found a roommate and moved into an apartment.

She enrolled in recovery and living skills classes, where she received training and earned a stipend for living expenses.

Today, Anna has her children back and she is working in a clinic as a peer support specialist.

She is a symbol of hope and recovery.

Let me also tell you about the Arizona State Hospital, which serves the most seriously mentally ill in our community.

There are four distinct populations – adult civil, adult criminal, juvenile and sexually violent persons.

We opened a wonderful new civil hospital two years ago, and we are eager to give you all a tour.

Recently, a federal Medicare team conducted a routine inspection of the hospital.

It’s a normal process that always turns up suggestions. 

We’ve had a follow-up visit, and today, we’re close to receiving a clean bill of health.

Now let me tell you about our licensing division… 

We license:

• Child care centers
• Assisted living centers
• Nursing homes
• Hospitals.

You often hear about us when there’s a problem at one of these facilities.

But what you don’t hear is how our employees prevent tragedies – and save lives.
Let me give you a recent example that makes me very proud as a director.

Just two weeks before Christmas, a nursing home in north Scottsdale announced it would be shutting its doors because the owners could not make payroll.

The facility is home to 113 frail, elderly residents – many with head injuries.

Some patients have been in the facility for 15 years.

So you can imagine that closing this nursing home would be a horrible thing to do at any time of year – not just Christmas.

The “transfer trauma” caused by moving frail individuals can literally be deadly … it’s a situation we want to avoid at all costs.

Our surveyors moved into action and worked around the clock to avoid a holiday nightmare.

First, they checked on all the residents to ensure their health and safety.

Second, we worked with the owners to try to find a solution.

There happened to be five owners – and each had an attorney – so believe me, this was no easy task.
Our staff worked night and day to keep the facility open until a new owner could be found.

With help from the Attorney General’s office, we reached a settlement just before Christmas.

On December 23, the nursing home had a small celebration – and I think we received the greatest gift of all.

At the party, a resident approached Mary Wiley, our assistant director in charge of licensing, and said:

“Thank you for saving our home.”

Now I’d like to explain just how important public health is – especially in times of crisis.

We have rebuilt, piece by piece, Arizona’s public health infrastructure so that now we are better prepared to deal with public health emergencies – including bioterrorism.

What you may not realize is that our job is to protect entire populations – to look at “big picture problems” and to seek solutions.

Let me give you a recent example.

This summer, we knew West Nile virus would hit Arizona hard.

In fact, a year ago, we came before this committee so you would be prepared to help constituents understand this issue.

To make a long and complicated scientific story short – it was simply our turn for a bad West Nile year.

But we were not helpless to stop it.

Once the disease arrived in the state, our epidemiologists worked non-stop to identify West Nile hot spots. 

Through precise mapping, they targeted those danger zones to prevent the virus from spreading.

The fact is: from extensive research, we knew what to look for, and we knew what measures to take to prevent a widespread outbreak.

My point is that we know diseases like West Nile virus – as well as other public health crises -- can be prevented.

Here are just a few of the other problems we’re trying to solve in public health:

• How do we deal with Arizona’s obesity epidemic?
• How do we get the message to young people that life is beautiful and that they should “inhale life” – not cigarettes?
• How do we deal with the challenges presented by Arizona’s growing elderly population?

In the not so distant past – about four years ago, exactly -- our role was much clearer.

My perception of our responsibilities in public health was pretty basic:

• Vaccinations
• Disease prevention
• Food safety
• Data collection

Since 9/11, our lives – and my life -- in public health have changed dramatically.

Last year, thanks to the Arizona Legislature, we opened Arizona’s new state of the art Health Laboratory, which puts us at the forefront of biodefense preparedness.

Our new lab has a biosafety level of 3, making it the highest rated lab in the state.

The next highest level is biosafety 4, which you will find at the centers for disease control in Atlanta.

Let me tell you why this is so important.

Just recently, we were brought a suspicious powder from a local company that had been identified through a field test as the deadly bioterror agent ricin.

Thankfully, our scientists quickly ruled out ricin … and declared the powder to be harmless.

It’s important to note just how much we’ve accomplished in just a few years in contributing to the security of Arizona residents.

With these advances, today we are better prepared to prevent and respond to any public health emergency.

Now I can’t leave without a few words about the simple things we can all do to promote public health.

If you smoke, we can help you to stop. 

Just go to http://www.GoColdTurkey.com for more information.

Today, try to take time for a little physical activity.

It’s scientifically proven that a little physical exercise can reduce the risk of developing diseases like heart disease and diabetes.

Every Tuesday and Thursday, a group of health employees takes a 15-minute walk around the capitol as part of my director’s challenge to become more physically active.

I’ve left you with a pedometer – and invite you to join us!

Now I’d like to tell you about our legislative package.

The department has four bills this legislative session, they will be:

Behavioral health loan repayment: this bill would expand the current loan repayment program to include behavioral health providers. The department has identified federal funding for this program and would not be requesting any general fund dollars for the program.

Newborn screening: the department is continuing to work on the issues of newborn screening regarding new metabolic tests and issues related to the current hearing tests. We’re not completely ready, but will continue to work with all concerned.

Trauma designation – delegation authority: this bill clarifies last year’s legislation that allows for trauma center designation.

Controlling person definition for health care institutions: the licensing statutes governing health care institutions, does not contain a definition of “controlling person”. Without a clear definition, a person with a history of licensing violations can reorganize and apply for a new license under a new entity name. Similar legislation was passed for childcare facilities.

As of today we don’t yet have bill numbers for these bills.

We would be happy to take questions now.