Despite all of the spending reductions, fund transfers, and other techniques used to balance the budget in the preceding few years, Arizona’s general fund faces a massive deficit. This issue of Policy Points poses an important question: Are you content with the historically low expenditures being made from the general fund and satisfied that the current low level of public services will be permanent?

This report follows The Coming of Age report produced in 2002 by some of the principals involved in this project, and published by St. Luke’s Health Initiatives. That research showed that Arizona had much to do to get ready for the baby boomer age wave. The results of Unlocking Resilience from new survey data, interviews, and secondary research indicates Arizona still has much to do to prepare for aging and must make concrete policy decisions about aging.

Severe and widespread budget cuts in behavioral health and substance abuse services for lower-income Arizonans who don’t qualify for AHCCCS have already taken effect across the state. Even before these cuts were implemented, it was clear that the publicly-supported behavioral health system in our state was not adequately serving many Arizonans who needed mental health or substance use disorder treatment. This paper represents an effort by Arizona State University’s Centers for Applied Behavioral Health Policy and the Morrison Institute for Public Policy to promote and enrich Arizona’s public dialogue about these problems and potential solutions.

Arizona’s public behavioral health care system, which serves some 150,000 mentally ill and vulnerable state residents, is wrestling with a number of urgent challenges. In addition to budget cuts resulting from the current economic crisis, and the demands of a 28-year-old class-action lawsuit, the system has been repeatedly criticized in several areas, including for inadequate staff, data, housing support, and crisis services. On July 22, a panel of professionals who play key roles in the system discussed these and other issues before some 300 behavioral health providers, supervisors, and policymakers at the annual Summer Institute hosted by Arizona State University’s Center for Applied Behavioral Health Policy. This paper provides an abbreviated report of that discussion, which was partially designed and moderated by ASU’s Morrison Institute for Public Policy.

Aging affects all dimensions of our society, but none so much as health care. Thus, St. Luke’s Health Initiatives (SLHI) decided to dedicate part of its Arizona Health Futures program to exploring Arizona’s capacity to meet the health care demands of an aging population. SLHI asked the Arizona State University School of Public Affairs and Morrison Institute for Public Policy to collaborate on The Coming of Age to inform Arizona’s policy leaders and residents about these critical issues. The Coming of Age engaged demographers, economists, public policy analysts, human service and medical professionals and citizens. Through its research, the team developed a realistic picture of Arizona’s "capacity to care" for an elder population. The results of the research are presented in The Coming of Age: Aging, Health and Arizona’s Capacity to Care.

St. Luke's Health Initiatives and the Flinn Foundation strive to make Arizona a better place to live for all of its residents. Despite our state's assets, Arizona has many issues to address, with health and poverty among the most important. Our organizations have been pleased to sponsor the state capacity research that provided the background and impetus for "More Promises to Keep: Sustaining Arizona's Capacity for Welfare and Health Reform." St. Luke's Health Initiatives and the Flinn Foundation view the information and analysis provided in this report as a good way to stimulate discussion of health and welfare policy options and community actions. Research and dialogue are essential steps in the process of constructive change, as is communication with the public. We urge readers to consider the ideas presented in this paper and to continue to work together to improve the health and welfare of all Arizonans.

The reality of an aging nation has been discussed so much that the statistics no longer shock us. The figures, though, can still prompt us to marvel at the tremendous effect that more people living longer is having on our communities. Our goal now for metropolitan Phoenix is to implement the ideas behind Life Options in real time with real people. Demonstration sites are the next logical step, and pilot planning builds on the significant accomplishments of the Maricopa County Commission on Productive Aging. Between September 2002 and January 2003, this group of 71 community leaders studied how aging and retirement are changing and how new ideas about service, community spaces, and choices might be put into practice. The Commission’s energy and insights began an exciting process of change in metropolitan Phoenix and set the stage for this Life Options Initiative.