Posted: May 1, 2013 10:00 PM
TUCSON - Arizonans who need mental health care may be startled to learn that their zip code has a lot to do with the care they get.
And you the taxpayer may be startled to hear that it could be costing you more.
About two years ago the state changed where and how patients on AHCCCS get that mental health care to align with medical care.
There are several Regional Behavioral Health Authorities (RBHA) in Arizona. Which RBHA a patient is assigned to used to be determined by county line, but two years ago the state starting using a client's zip code instead.
Russell Valenzuela of Arivaca Junction near Green Valley has been fighting this change for nearly two years with no results. He called the News 4 Tucson Investigators for help.
"I'm constantly on the road going to Tucson to see a counselor from Sierra Vista...on a T.V. screen. It doesn't make sense."
Russell used to go to Green Valley which is 8 miles and just ten minutes up the road for all his care.
Russell still goes to Green Valley for group therapy.
"But my meds and everything else I have to go to Cenpatico, and that's CEABHS in Tucson."
So here's the problem. Russell lives just a few yards north of the Santa Cruz County line. While he's in Pima County, folks here get their mail at the Amado Community Post Office which is a sub-station of the Tumacacori Post Office and that comes back with zip code in Santa Cruz County.
So clients like Russell were switched to Cenpatico, the RBHA for much of southeast Arizona.
Russell says there are about 20 people in his community who need treatment. The extra miles and time are discouraging some of them to get the services they need Russell tells us.
Most who still go don't drive so taxpayers pay for their rides.
In Russell's case that means a car is dispatched from Benson, picks him up at home, drives him to Tucson and back. That's a 200 plus mile drive every week for what used to be a 16 mile round trip to a provider in Green Valley.
So we wanted to know, when it makes more sense for Russell to get services in Green Valley like he used to, is there a mechanism in place to allow that?
Terry Stevens is C.EO. of Cenpatico. She tells us they try to accommodate clients. Stevens says she attempted to enter a Specialty Service Provider contract but that didn't work.
"One particular provider that had been providing services in that area refused to contract with us," Stevens tells us by phone.
We called that provider, COPE Community Services, and they say that's not true. Via email Tom Donovan C.E.O. of COPE provided this statement:
COPE has not been approached by Cenpatico for a contract to provide Behavioral Health Services for the members affected by the zip code changes. We have participated in single case agreements with Cenpatico. We would welcome the opportunity for a full service contract with Cenpatico for those members.
We also heard from the Arizona Department of Health Services.
"Obviously, in a managed-care environment, we try to make sure that the RBHA's do their job that they're contracted to do," says Cory Nelson, Deputy Director of ADHS Dept. of Behavioral Health. "And try to work those out between themselves. However, ultimately the state has the responsibility for the contract, and can step in."
Nelson says he urges patients like Russell to contact the state if they are in the same situation. You can call 1-800-867-5808 or email firstname.lastname@example.org for assistance.
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