Arizona State and Local Government Documents Collection

The Arizona Health Care Cost Containment System has provided home and community-based services to long-term care beneficiaries through a waiver from the Centers for Medicare and Medicaid Services since 1989. Through its Arizona Long Term Care System, AHCCCS provides comprehensive coverage for members residing in their own homes or approved alternative residential settings, such as assisted living facilities or group homes. Covered services include care such as home health nursing, attendant or personal care, and home-delivered meals. Members may designate a family member or friend to provide attendant care; after completion of training, these caregivers can be paid by AHCCCS.

The potential impact of diabetes on the Arizona Long Term Care System is of significant concern to AHCCCS. Based on this and previous studies conducted by AHCCCS, the prevalence of diabetes among ALTCS members is approximately 20 percent. With the number of Arizonans age 65 and older increasing 40 percent in the last decade, the proportion of ALTCS members with diabetes is likely to increase as well.

This report includes data on preventive health and chronic disease management services provided to members enrolled with nine publicly and privately operated managed care organizations, referred to as Contractors, that contract with AHCCCS to provide services under the AHCCCS ACUTE-care program. Performance measure results for services provided through the Department of Economic Security’s Division of Developmental Disabilities are reported in a separate section of the report. Results should be viewed as indicators of utilization of services, rather than absolute rates. These data allow AHCCCS and its Contractors to identify areas for improvement and implement interventions to increase the use of preventive and evidence based chronic disease management services.

The Arizona Health Care Cost Containment System (AHCCCS) is the State's Medicaid and KidsCare program offering the following behavioral health services: Title XIX (Medicaid) Acute and Long Term Care, Acute Care, Arizona Long Term Care Services (ALTCS), Federal Emergency Services Program (FESP), and Title XXI (KidsCare).

For more information concerning comprehensive medical services and additional information regarding behavioral health services refer to the AHCCCS Medical Policy Manual.

Students FIRST (Fair and Immediate Resources for Students Today) was enacted July 9, 1998. This paper will focus on (1) the facts and direct rationale behind the payment for K-12 school construction from a pool of current general fund dollars, as mandated in the Students FIRST provisions; and (2) the implications and logical consequences of bonding versus paying for capital improvements with cash on an annual basis. 'Track 1' designates the status quo strategy of cash payment for capital improvements, while 'Track 2' represents a strategy for bonding that distributes the costs of the projects to taxpayers over the course of their useful life.

Various measures of Arizona state government expenditures suggest that state spending has increased substantially, both in recent years and during a longer period stretching back to 1990. However, increases are much more modest after adjusting for inflation and the state's rapid population growth. Further, the spending increases generally have been in line with the gains in various measures of income.

The state government general fund shortfall in the next fiscal year is projected to be $2.4 billion. A projected shortfall of $1.6 billion will need to be closed through spending reductions and/or revenue enhancements. The Legislature has focused on reductions in funding to state agencies. However demand does not decline for most public-sector services during a recession. Spending reductions by governments during recessions also worsen economic conditions. State spending cuts would worsen and lengthen the economic recession. The negative economic effects from a personal tax increase would be less than those of a governmental spending decrease. The demand for university services also does not drop during recessions. Any reduction in funding for universities will have a negative and direct effect. A substantial decrease in state government funding for universities will have negative consequences beyond these short-term effects. Any action--such as budget cuts--that undermines the success of the state's universities also impairs the state's economy.