This report was compiled by members of the Injury Prevention Advisory Council Subcommittee on Violence. Its purpose is to present an overview of youth violence in Arizona, using data from the health care and criminal justice systems. Presenting both the health care and criminal justice perspectives presents a more comprehensive picture of youth violence and provides greater opportunities for developing solutions.

Since the release of the CDC’s recommendations to improve preconception health in 2006, the Arizona Department of Health Services and its partners across the state have made steady progress in improving awareness about preconception health and increasing access to preconception health services. The Bureau of Women’s and Children’s Health assessed internal programs serving women and children to identify opportunities for integrating preconception health education and services into program policies and procedures.

The Arizona Injury Surveillance and Prevention Plan establishes objectives and proposes strategic actions to avoid injury. The actions proposed are based on the knowledge that many seemingly accidental injuries could have been prevented by taking precautions, avoiding unnecessary risks, and/or enacting and enforcing laws such as drunk driving laws or seat belt laws.

The Arizona Department of Health Services offers a vast array of programs that benefit every state resident and visitor. I like to remind people that we are with you from birth to death. In fact, we provide certificates for both events through our Office of Vital Records. If you drink the water, eat the food, require hospital or nursing home care or use a child care facility, the Arizona Department of Health Services has touched your life in some important way. Assuring the quality of our food and water, setting standards for hospitals and nursing home and child care, maintaining the State’s vital records, screening newborns for genetic diseases, protecting the public from disease and overseeing the state’s mental health system and Arizona State Hospital are just some of the duties of the Arizona Department of Health Services.

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.

While virtually all children have contact with the health care system at some point, many problems may not be detected until children enter school. By offering low-income families and children access to health care and a regular point of contact, the AHCCCS program is uniquely positioned to provide high-quality, comprehensive preventive services that help assure the healthy development of children.

This report analyzes Contractor Performance Indicators in three perinatal areas: 1) Low Birth Weight Deliveries; 2) Prenatal Care in the First Trimester; 3) Initiation of Prenatal Care. The results of this analysis should be viewed as indicators of access to services, rather than absolute rates for how well AHCCCS and/or its Contractors provide care.

This report includes results for the measurement period from October 1, 2000, through September 30, 2001. Results of the indicators are reported in aggregate by urban (Maricopa and Pima counties) and rural areas, and by individual Contractors that provide services to Medicaid recipients.