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.

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.

Since statehood in 1912, Arizona has been among the nation’s leaders in using the initiative process to either adopt a statute or amend the state constitution by placing a measure on the ballot. But such efforts are anything but easy. In fact, organizers have found it to be an expensive, time-consuming and exhausting process – and one that is unlikely to end successfully.

The author writes about Arizona's longstanding belief in direct democracy via referendum, initiative and recall. The Legislature continues to grapple with election reform and strike a balance of how much binding authority should remain in the hands of voters in terms of initiative, referendum and recall, but Arizona’s penchant for people power has been demonstrated since before statehood. In the midst of his campaign for Congress in 1911, for example, Arizona’s Carl Hayden noted that everywhere he went he found voters eager to take control. "The people want their own kind of government,” Hayden told reporters. “They want to be the dictators.”

This paper, drawing upon historical data and information from surveys and interviews with more than 50 legislators, lobbyists, and knowledgeable observers, finds that the term limits reform adopted by the Arizona voters in 1992 has caused legislators to make some painful adjustments. Because of term limits many legislators have decided to run for another office prior to the expiration of their terms. This has often meant trying to move from the one legislative house to another, most commonly from the House to the Senate. On the plus side, the report finds that term limits have encouraged greater competition for legislative and other seats and have given voters a greater choice among candidates. To some extent, limits have been a force toward a more inclusive governing process. At the same time, they have generally reduced the power of legislative leaders and generally increased the influence of lobbyists and staff, though not all lobbyists and staff have gained equally. Recent newcomers to the Arizona Legislature are probably not any less knowledgeable than previous classes of newcomers, but under term limits there are more newcomers and members have less time to learn their jobs. For many, the limit to four two-year terms (eight years total) provides too little time to learn how to do the job and do it well.