Engaging decision makers for Arizonans with serious mental illness

One hand comforts another
Problem Statement

The Office of Human Rights at the Arizona Health Care Cost Containment System (AHCCCS) provides individuals living with a Serious Mental Illness designation with advocacy to help them understand, protect, and exercise their rights. Contact and engagement with health care decision makers is critical to helping OHR facilitate self-advocacy through education and help individuals access behavioral health services. 

In 2023, 102 AHCCCS members qualified for serious mental illness Special Assistance, yet OHR was only able to contact 61 of their health care decision makers (HCDMs), meaning that approximately 40% of HCDMs did not receive valuable resources that could have helped them secure services for both themselves as caregivers and people who qualify for Special Assistance. 

Action Taken

This gap, coupled with community feedback, highlighted the need to analyze and optimize processes to provide targeted education to health care decision makers. Going without access to support and resources negatively impacts individuals living with a serious mental illness designation as well as their families, potentially extending the time it takes to obtain appropriate services in a behavioral health delivery system that can seem overwhelming and burdensome.

After evaluating ways to use technology to streamline and accelerate advocacy efforts, OHR added a mandatory email address field in the Quality Management Portal to collect HCDM email addresses when a member is assigned Special Assistance advocacy.

OHR created a resource letter in English and Spanish detailing commonly requested resources and reiterating discussion points provided to the HCDM during an outreach phone call. The letter points to self-advocacy tools such as the formal grievance and appeal process and includes:

  • A detailed explanation of Special Assistance,
  • OHR contact information,
  • the AHCCCS Medical Policy Manual 320-R for Special Assistance,
  • the Arizona Administrative Code and the role of the designated representative,
  • the OHR Advocate of the Day phone number and technical assistance,
  • a link to the OHR web page to locate presentations and educational materials on frequently asked questions and processes, and
  • a link to the AHCCCS Office of Individual and Family Affairs Empowerment Tools webpage with learning materials on navigating the behavioral health delivery system.


OHR used the following Arizona Management System concepts for this improvement effort: 

  • The 5S process: Working with the AHCCCS development team to upgrade the Quality Management Portal and the development and launch of the resource letter utilized the elements of sort, simplify, shine, standardize and sustain.
  • Just Do It: Specific project goals were identified, designated individuals were assigned tasks and status updates were monitored.
  • Voice of the Customer: Through community training, OHR became aware of the knowledge gap of the available resources pertinent to Special Assistance, the accompanying codes and policy and what support OHR provides.
Results & Impact

Since beginning to collect HCDM email addresses, OHR has recorded a 41% increase in the contact rate. OHR is now able to send resources to 100% of health care decision makers serving Special Assistance members.