2002 Annual Report Leadership for a Healthy Arizona Director’s Message I was deeply honored when Gov. Janet Napolitano reappointed me as Director of the Arizona Department of Health Services. In my last two years as Director, I believe we have made major strides to improve the Department and the health status of Arizona’s residents. The accomplishments that you’ll read about in this Annual Report provide a strong testament to how far we have come as a Department - and as a state. 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. Governor Napolitano is committed to improving the health status of Arizona residents, and I will continue to work tirelessly to improve the Arizona Department of Health Services and to meet the Governor’s goals for public and behavioral health. I am also very fortunate to be working with an extremely professional and dedicated staff whose reputation for quality and excellence is known across the country. If you would like to learn more about the Department, please visit our Web site at www.hs.state.az.us. Sincerely, Catherine Eden Mission Statement The mission of the Department of Health Services is: Setting the standard for personal and community health through direct care delivery, science, public policy, and leadership. 1 Who We Are • Educating the public about the dangers of smoking, and providing smoking cessation services to thousands of Arizonans through the Arizona Smokers’ Help Line. The Arizona Department of Health Services is involved in a wide array of activities designed to promote and protect the health of Arizona citizens. These activities include: • Identifying public health threats by collecting health data, monitoring trends, and performing tests at the Arizona State Health Laboratory. • Educating and alerting the public and health care providers about public health threats. • Tracking outbreaks of communicable diseases such as HIV/AIDS and Hepatitis C, and providing medications and/or community service referrals. • Performing screenings of every Arizona newborn to detect eight metabolic disorders so that effective, early treatment is possible. • Gathering and retaining vaccination information to help ensure Arizona’s children are completing recommended vaccination schedules. • Coordinating the State’s Women, Infants, and Children program, a federal program aimed at providing nutritional foods for women and their children during pregnancy and postpartum. • Collecting and disseminating public records information, including birth and death certificates. Maj. William McCurtis, of the Arizona 9th Memorial Cavalry “Living Historians of the Buffalo Soldiers” with Arizona State Hospital employee Mary Towne kneel by the Medal of Honor headstone of Cpl. Isaiah Mays during a ceremony to honor Mays. He was awarded the Medal of Honor in 1890, and died at the State Hospital in 1925. • Supporting the primary care of nearly 50,000 uninsured individuals, and supporting the dental care of another 10,000 individuals. • Licensing and educating over 5,400 health care and over 3,100 child care facilities and group homes to ensure safety and high quality care for Arizonans. • Delivering publicly funded care to over 113,000 people annually with behavioral health care problems, directly through the Arizona State Hospital, and indirectly through our contracted Regional Behavioral Health Authorities. The entrance to new state of the art adult behavioral health facilities at the Arizona State Hospital. 2 Our Accomplishments The Arizona Department of Health Services’ accomplishments during 2002 were numerous. They include: • Opening a new, state-of-the-art adolescent and adult behavioral health facilities at the Arizona State Hospital. • Earning the distinction of being the first state health agency to win a federally funded bioterrorism preparedness grant from the federal Centers for Disease Control and Prevention (CDC). • Developing and submitting smallpox vaccination and response plans to the CDC. • Responding to more than 1,300 complaints made against childcare or group home providers and nearly 2,000 complaints made against health care providers. More than 90 percent of complaints alleging potential for harm were responded to on time. Director Catherine Eden, Sonoran Secretary of Public Health Dr. Jose Bernardo Cruz Ochoa, and Nogales, Sonora, Mayor Abrahan Zaide at a ribbon-cutting ceremony to open a triage and stabilization unit in Nogales. • Breaking ground for a new Arizona Department of Health Services building, an event that Director Catherine Eden said “marks the beginning of the reunification of the Department.” • Recovering more than $6 million from the federal government for services funded previously by the state through a massive data cleanup. • Supporting the primary care of nearly 50,000 uninsured individuals, and supporting the dental care of another 10,000 individuals. • Posting enforcement action information concerning child care and health care facilities on the Department’s Web site (www.hs.state.az.us) for the first time. • Helping to reduce Arizona’s teen (19 and younger) birth rate to a record low of 30.5 births per 1,000 girls. The Department provides a comprehensive “abstinence only” program to Arizona teenagers. • Providing 1,500 developmental evaluations for Children with Special Health Care needs - a 67 percent increase from the previous year. • Reducing youth smoking rates. Since 1997, smoking for Arizona’s high school students has dropped 21 percent. Smoking among middle school students dropped 39 percent. • Expanding the state’s newborn screening program to give Arizona babies an extra measure of protection. The Arizona Newborn Screening Program now tests Arizona babies for eight genetic disorders rather than seven. • Delivering publicly funded behavioral health care to more than 91,000 people with behavioral health problems, directly through the Arizona State Hospital, and through the Department’s contracted Regional Behavioral Health Authorities (RHBAs). • Providing public health support during the Rodeo-Chediski fire by issuing air quality health alerts to residents and distributing information to residents about how to recover from a fire. The Department’s Behavioral Health Division also provided counseling services to residents affected by the fire. • Increasing the number of Medicaid clients enrolled in the behavioral health system to 54,912 in June 2002 from 39,424 in July 2001. 3 • Earning awards and praise from the FBI for the State Health Laboratory’s response to the 2001 anthrax scare. Charlene B. Thornton, head of the Phoenix office of the FBI, said State Health Laboratory “proved to be a full and essential partner in the war on terrorism. The protocols developed by the lab, in cooperation with the FBI’s Phoenix office, today serve as a model for jurisdictions across the country.” During the anthrax scare, the State Lab tested more than 1,100 specimens submitted by law enforcement. None tested positive for anthrax. • The Department’s Office of Border Health and the U.S. Mexico Border Health Commission engineered a groundbreaking alliance with public health officials in Sonora, Mexico. A work agreement signed by Catherine Eden and her counterpart in Sonora, Dr. Bernardo Cruz Ochoa, is the Director Catherine Eden at a ceremony opening the first of its kind by two new adult and adolescent behavioral health facilities at states along the 2,000 the Arizona State Hospital. mile border. “We will join hands to fight tuberculosis, reduce infant mortality and promote health behaviors on both sides of the border,” Director Eden said during a signing ceremony. • Protecting the public health by testing statewide for West Nile virus. The Arizona State Health Laboratory tested more than 750 mosquito pools; 1,600 blood samples from sentinel chicken flocks placed strategically across the state; and more than 120 human specimens for West Nile virus. All were negative, except for three imported human cases. • Awarding 18 mini-grants to health promotion and assessment projects throughout the state through the Department’s “Healthy Arizona” 2010 program. • The Department’s Office of Border Health coordinated activities of the US/Mexico Border Diabetes Project, a five-year collaborative team effort attempting to determine prevalence of diabetes in the border region, develop binational prevention and control programs for diabetes, and respond to the needs of the border population. • The Department reached out to help residents affected by the Rodeo-Chediski fire with a toll-free counseling hotline. The 24-hour hotline was provided through the Department’s Northern Arizona mental health contractor, the Northern Arizona Regional Behavioral Health Authority. “The mental health effects of these devastating fires will be seen for months and even years to come,” said Dr. Michael Franczak of the ADHS Behavioral Health division. Deputy Director Danny Valenzuela speaks to public health professionals from both sides of the U.S.-Mexico border during a conference in Rio Rico sponsored by the Department’s Office of Border Health. 4 Our Plan for A Healthier Future Be prepared to respond to emergencies that threaten the health of Arizona’s residents. T he Arizona Department of Health Services’ FY 2002-2004 Strategic Plan outlines objectives that we are striving to achieve to meet new or existing public health threats and improve the quality and effectiveness of our services. These objectives include: • New and diverse threats, such as chemical and biological terrorism, school-based and workplace violence, and crises in health care access (e.g. hospital and nursing home closures, HMO pullouts) challenge the Department to be able to rapidly and efficiently respond to health emergencies. The Department is meeting this challenge by: strengthening our partnerships with federal, state, county, and tribal agencies, the media, the military, health care providers, and others; facilitating early warning, rapid communication systems; developing and refining policies and training programs, and conducting mock disaster drills. Respond to the State’s increasing older population and their health care needs. • The Department is developing new public health strategies to address significant expected increases in the number of Arizona seniors. We are also increasing our oversight of health care facilities. Such oversight is needed since expected increases in the numbers of people residing in nursing homes, assisted living centers, hospitals, hospices, and home health agencies, coupled with decreasing Medicare insurance reimbursements, increasing regulatory demands, and staffing shortages may otherwise lead towards decreased quality of care. Reduce the rate of injury - the leading cause of preventable death and disability in Arizona. • The Department is currently developing a statewide injury prevention plan and enhancing our injury surveillance system. Reduction of injury is critical to reducing emergency room overcrowding, physician visits, and costly long-term physical and psychological rehabilitative services. Arizona currently ranks among the six worst states in accidents, suicides, and homicides. Suicide among teens and seniors is of special concern. As many teens die here from suicide as homicide. Further, Arizona ranks among the worst five states in the nation for senior suicide. State Epidemiologist Dr. Bob England consults with Chief Medical Officer Dr. Cheryl McRill during a statewide bioterrorism exercise. A member of the National Guard sits in the foreground. 5 Our Plan for A Healthier Future w Improve the system for serving persons with behavioral health problems. ww • The Department is taking a variety of steps to improve the behavioral health system. Several efforts center on ensuring that people with behavioral health care problems have greater access to services that fit their individual needs. Provider networks and service delivery systems are being changed, allowing for better integration of mental health and substance abuse services and greater flexibility in service delivery. Efforts are being made to maximize the use of federal dollars to pay for services, resulting in increased service access while minimizing the cost to the State. At the same time, improvements are being made in performance monitoring to ensure that delivered services are effective. Meet the increasing demand for the electronic movement of data and electronic service delivery through the Internet. • To meet the increasing demand for information and services over the Internet, the Department is planning to bring key agency services on-line such as: ordering certified copies of birth and death certificates; applying for and renewing health and child care facility licenses; and expanding access to the Department’s immunization registry. The Department is also working to improve efforts at coordinating its services with other State agencies. We are beginning to work with the AHCCCS health plans to identify primary care physicians who are best suited to work with our behavioral health clients. We are also working to develop and maintain a coordinated system of care for children referred by other state agencies for behavioral health services, once again by increasing service accessibility and flexibility. Pursue proactive regulation, with an emphasis on collaborations, education, and partnerships, while maintaining effective and fair enforcement. • The Department of Health Services is working to increase regulatory compliance by licensed health care and childcare providers through new education and technical assistance efforts. Simultaneously, the Department is working to enhance the current regulatory system by improving the timeliness of licensing, inspections, complaint investigations, and enforcement actions. Department epidemiologists Cynthia Snyder and Shoana Anderson examine health data during a statewide bioterrorism exercise. 6 Arizona Department of Health Services Expenditures by Program Fiscal Year 2001-2002 PROGRAM ADMINISTRATION Administrative Services Director's Office Information & Technology Services (ITS) Business & Financial Services TOTAL STATE FUNDS 1,503,816 1,522,896 7,055,331 6,612,496 16,694,539 ASSISTANCE TO OTHERS STATE 500 1,024,098 435,997 3,043 1,669,811 2,937,967 6,070,917 COMMUNITY AND FAMILY HEALTH Bureau Chief Children W/Special Health Care Needs Women & Children Health Nutrition Oral Health Prevention & Health Promotion TOTAL 1,659,334 26,983 1,066,708 486,052 372,117 530,245 4,141,439 19,000 9,727,513 680,024 380,250 645,408 1,351,174 632,761 3,071,099 6,380,466 EMERGENCY MEDICAL SERVICES Bureau Chief EMS Operations EMS Programs TOTAL 1,882,802 317,444 2,200,246 11,440 25,445 440,852 1,492,340 1,970,077 500 ASSURANCE & LICENSURE Licensure Administration Enforcement Training Quality Assurance Child Care Licensure Health Care Licensure Certification TOTAL EPIDEMIOLOGY AND DISEASE CONTROL Bureau Chief Bioterrorism Environmental Health HIV/AIDS/STD Services Infectious Disease Control Immunization (Vaccine) TOTAL OTHER FUNDS 246,884 1,134,990 -2,302 396,550 196,609 593,158 191,961 94,899 496,786 1,237,911 1,783,269 0 3,619,515 3,906,376 36,478 33,449,730 2,520,649 616,929 125,731 36,749,516 255,221 551,204 4,847,271 4,847,271 0 ASSISTANCE TO OTHERS FEDERAL TOTAL -4,493 -4,493 1,515,256 1,546,540 7,892,733 8,296,952 19,251,480 -2,302 295,984 1,762,124 FEDERAL FUNDS 36,541 12,031 96,362 878,053 2,094,909 1,346,136 3,302 107,766 4,526,528 3,783,550 5,129,920 795,043 ASSISTANCE TO OTHERS OTHER 3,000,000 3,000,000 1,252,601 542,928 3,043 2,166,597 7,795,393 11,760,563 520,726 728,145 2,267,104 5,346,049 322,844 1,209,728 10,394,597 815,975 1,500,616 3,143,007 102,424,149 384,561 2,793,209 111,061,517 3,128,875 40,367,076 16,222,297 111,014,358 1,082,826 4,785,680 176,601,111 213,382 6,548 354,143 6,695,042 1,384,115 2,251,916 10,905,145 16,000 114,421 5,935,996 460,700 1,853,888 8,381,005 1,289,656 120,969 999,551 14,525,079 3,612,565 7,432,123 27,979,943 163,703 163,703 0 1,882,802 8,365,441 10,248,243 37,024 37,024 Page 1 of 2 7 Arizona Department of Health Services Expenditures by Program Fiscal Year 2001-2002 – Continued STATE LABORATORY SERVICES Bureau Chief LAB Quality Assurance Environmental & Analytical Chemistry LAB License, Certification & Training Environmental & Clinical Microbiology Lab Support & Technical Services TOTAL 738,633 14,214 771,311 218,258 1,366,321 316,043 3,424,780 MEDICAL AND PUBLIC HEALTH SERVICES Assistant Director Vital Records Health System Development Health Registry Public Health Statistic TOTAL 25,068,622 1,423,537 623,107 535,765 1,581,958 29,232,988 BEHAVIOR HEALTH SERVICES Assistant Director Community Behavioral Health** Arizona State Hospital TOTAL 6,390,499 13,428,443 47,543,317 67,362,259 135,507,634 DEPARTMENT TOTALS 17,039,405 25,455 -23 764,065 14,214 1,033,569 951,807 3,643,447 345,564 6,752,666 246,170 553,946 1,511,007 29,893 2,366,472 16,088 179,603 766,118 -372 961,414 7,442 90,016 232 140,933 151,982 238,624 0 252,756 280,742 172,336 351,319 214,752 1,271,905 1,873,162 400,501,347 51,759 1,282,429 36,457,402 125,078,562 534,354 15,631,101 1,116,612 17,282,067 402,374,509 1,334,188 36,457,402 8,850,275 592,378,782 48,659,929 649,888,986 173,656,641 28,718,241 442,121,723 29,403,807 156,211,115 965,619,162 13,201,268 2,000,000 32,240,672 500 125,078,062 25,000 126,982 **BHS State Matching Transfer to AHCCCS Internal Service Funds Amount 42,393,225 1,794,295 14,123,923 1,028,017 3,796,710 63,136,171 110,187,714 187,267 1,075,994,142 NOTE: EXPENDITURES ARE REPORTED AS OF JUNE 30, 2002 THIRTEENTH MONTH PRIMARILY ON A CASH BASIS. ASSISTANCE TO OTHERS SUMMARY: STATE OTHER FEDERAL 173,656,641 442,121,723 156,211,115 Exhibit "A" Programs Administered by Counties 771,989,479 39,817,807 Exhibit "B" Programs Administered by Other Organizations 732,171,673 771,989,480 * Tobacco Tax Funds are identified as State Funds. * Expenditures for Vital Records are recorded under MPHS. * Expenditures for Library are recorded under MPHS - AD * Expenditures for HCCRS are recorded under Assurance & Licensure **$110,187,713.87 in operating transfer were removed from BHS/COMBEHV State Funds and FHS/CWSHC State Funds. These funds were a transfer of State Appropriations to AHCCCS and were received back matched with Federal $. 8 Page 2 of 2 Arizona Department of Health Services Assistance to Others Programs Administered by Counties Fiscal Year 2001-2002 * S = STATE FUNDS * F = FEDERAL GRANT FUNDS * O = OTHER FUNDS APACHE ADMINISTRATION Director's Office GILA GRAHAM GREENLEE LA PAZ MARICOPA MOHAVE NAVAJO PIMA PINAL SANTA CRUZ 183,316 40,564 29,792 69,074 56,890 124,473 6,651,327 54,442 250,960 255,678 1,597 601,888 267,150 24,110 148,660 533,304 5,967 8,401 307,509 1,515,686 4,331 6,250 218,896 138,388 852,694 22,339 2,500 100,710 71,429 95,725 54,365 51,750 48,000 195,362 70,942 81,848 1,000 1,000 1,000 148,268 1,403,175 349,174 70,596 27,303 900,037 76,469 22,814 21,924 92,815 49,160 YAVAPAI YUMA TOTAL 90,497 60,540 180,784 464,839 35,535 59,089 748,914 101,025 779,229 12,583,044 267,435 293,594 681,091 1,808 1,927,786 1,146,074 756,154 O COMMUNITY AND FAMILY HEALTH SERVICES Bureau Chief F Children w/Spec Health Care Needs F Nutrition S Nutrition F Nutrition O Oral Health F Prevention & Health Promotion F Prevention & Health Promotion O Office of Women & Children Hlth S Office of Women & Children Hlth F Office of Women & Children Hlth O EMERGENCY MEDICAL SERVICES Programs S MEDICAL & PUBLIC HEALTH Office of Assistant Dir Office of Assistant Dir Health System Development S F S BEHAVIORAL HEALTH SERVICES Community Behavioral Hlth F 32,925 64,010 3,527 74,641 44,573 526,651 22,750 EPIDEMIOLOGY AND DISEASE CONTROL Bureau Chief F Bioterrorism F HIV/AIDS/STD Services S HIV/AIDS/STD Services F Office of Infectious Diseases S Office of Infectious Diseases F Vaccine F T OT A L COCHISE COCONINO 83,505 40,485 56,080 472,001 131,539 32,884 12,700 39,253 5,253 107,688 21,525 179,442 5,016 500 27,923 8,996 211 33,017 35,300 6,271 7,995 28,300 12,740 28,300 16,426 1,000 1,000 44,265 12,196 50,000 106,274 47,165 60,000 148,773 118,647 83,120 43,567 800 27,485 1,000 1,000 21,000 1,000 1,000 1,000 9,373 16,000 151,904 49,520 1,000 17,795 30,306 380,282 53,762 9,104 34,168 11,721 23,466 2,771 22,432 33,565 83,718 38,806 39,899 53,543 21,299 21,235 102,179 30,278 8,269 47,066 869,339 8,265 10,000 28,826 112,908 20,050 196,717 42,690 182,846 268,042 90,000 236,419 132,892 88,510 1,000 13,667 47,057 506,215 207,734 1,000 15,294 14,154 52,887 42,312 1,000 1,000 10,500 270,194 49,746 1,000 11,165 7,100 148,336 28,866 34,500 73,778 33,072 45,734 237,932 105,275 229,494 104,638 8,818 270,181 489,422 639,712 244,243 206,756 15,000 89,421 246,884 3,040,184 1,048,902 1,825,131 8,818 128,897 165,237 5,601,972 643,502 321,854 2,102,920 231,053 315,034 231,527 171,986 642,256 1,034,560 586,705 12,590,219 0 1,437,599 0 801,476 1,645,237 2,341,394 553,460 579,993 260,951 270,471 NOTE: SOME PROGRAMS ADMINISTERED BY ONE COUNTY MAY BENEFIT ONE OR MORE ADJOINING COUNTIES. 16,920,747 1,777,152 866,535 5,399,661 2,165,610 364,022 3,348,970 2,522,128 39,817,807 Exhibit “A” 9 Arizona Department of Health Services Assistance to Others Programs Administered by Other Organizations Fiscal Year 2001-2002 * S = STATE FUNDS * F = FEDERAL GRANT FUNDS * O = OTHER FUNDS NARBHA PGBHA CPSA #3 CPSA #5 EXCEL OPTIONS HEALTHCARE COLO RIVER INDIAN TRIBE GILA RIVER INDIAN TRIBE PASCUA YAQUI TRIBE NAVAJO TRIBE OTHER ARIZONA TRIBES STATE WIDE TOTALS ADMINISTRATION Administrative Services Administrative Services Administrative Services S O F 500 -2,302 -4,493 500 -2,30 -4,493 MEDICAL & PUBLIC HEALTH Assistant Dirctor Assistant Dirctor Assistant Dirctor Health System Development Health System Development Public Health Statistic S F O S F S 4,449,186 25,000 11,763,669 126,982 2,000,000 4,449,186 25,000 0 11,763,669 126,982 2,000,000 EMERGENCY MEDICAL SERVICES Programs Programs Programs F O S 163,703 3,000,000 4,838,452 163,703 3,000,000 4,838,452 EPIDEMIOLOGY AND DISEASE CONTROL Bureau Chief Bureau Chief Bioterrorism Environmental Health Environmental Health HIV/AIDS/STD Services Infectious Disease Control Infectious Disease Control Infectious Disease Control Vaccine Vaccine S F F F S F S O F S F 380,250 28,757 380,250 1,000 25,000 0 0 2,895,812 86,087 0 231,206 0 28,757 FAMILY HEALTH SERVICES Bureau Chief Bureau Chief Bureau Chief Children's W/Special H/C Needs Children's W/Special H/C Needs Children's W/Special H/C Needs Nutrition Nutrition Nutrition Prevention & Health Promotion Prevention & Health Promotion Prevention & Health Promotion Office of Women & Children Hlth Office of Women & Children Hlth Office of Women & Children Hlth Oral Health S F O S F O F O S S F O S F O F 63,811 36,478 3,783,550 1,399,591 33,449,730 89,808,331 328,916 15,814 19,000 2,112,117 123,923 3,202,133 1,994,434 1,764,495 90,967 0 67,061 36,478 3,783,550 1,399,591 33,449,730 89,841,105 349,494 15,814 19,000 2,112,117 123,923 3,202,133 1,996,934 1,764,495 90,967 BEHAVIORAL HEALTH SERVICES Assistant Director Assistant Director Community Behavioral Hlth Community Behavioral Hlth Community Behavioral Hlth O S S O F 10,750 500 650,325 74,659 537,407 1,873,162 500 125,078,062 400,501,347 36,457,402 169,322,130 732,171,673 1,000 25,000 4,834 7,828 63,116 7,267 22,972 46,594 2,000 184,612 1,250 32,774 20,577 2,500 154,525 116,994 1,590,893 13,850,522 46,277,580 3,123,878 6,367,578 20,607,414 1,652,925 5,806,086 16,945,987 1,372,062 27,112,342 77,338,749 8,218,854 5,139,370 16,717,706 1,186,584 64,771,301 222,079,043 20,168,794 180,200 317,879 209,202 196,898 224,373 124,215 658,086 126,791 63,406,505 28,627,917 24,124,135 112,669,945 23,160,654 308,610,031 180,200 724,979 376,000 902,415 NOTE: PROGRAMS ADMINISTERED PRIMARILY BY NON-PROFIT ORGANIZATIONS AND INDIANS TRIBES FOR RECIPIENTS QUALIFYING UNDER THE PROGRAMS. 10 2,875,883 66,762 Exhibit “B” Arizona Department of Health Services Arizona State Hospital Financial Summary Fiscal Year 2001-2002 Funding Sources (General Operations Based on Budget Allocations):* Personnel Services and Related Benefits - General Fund All Other Operating - General Fund/AZ State Hosp Fund Non-Title 36 Revenue Rental Income Endowment Earnings Patient Benefit Fund Donations Psychotropic Medications Community Placement - General Fund Community Placement Treatment - AZ State Hosp Fund Male Restoration to Competency Self Care Unit Total Funding $28,304,900 10,126,600 150,000 526,185 400,000 81,000 20,000 63,500 1,095,600 5,609,200 510,796 183,024 $47,070,805 Expenditures:* Personnel Services and Related Benefits Professional and Outside Services** Travel (In-State) Travel (Out-of-State) Food Other Operating Capital Equipment Assistance to Others Total Cost of Operations $28,188,582 6,285,188 54,180 4,371 -04,241,895 237,463 5,608,600 $44,620,279 Collections (Deposited to the General Fund): Patient Care Collections to the General Fund $449,329 Patient Care Collections to AZ State Hosp Fund (RTC) 6,081,374 Patient Care Collections to AZ State Hosp Fund (Title XIX) 1,319,374 Non-Patient Care Collections to the General Fund 1,909 Collections to Other Funds 19,615 Total General Fund Collections $7,871,601 * ** Excludes SVP Program Contract Physicians, Outside Hospitalization Costs, Outside Medical Services, and privatization of Support Services Daily Costs by Treatment Program:*** Medical Psychiatric Adolescent Treatment Special Psychiatric Rehabilitation Psychiatric Rehabilitation Forensic - Restoration to Competency Forensic - Rehabilitation Average Daily Treatment Costs**** *** Rates became effective 09/01/99. ****Weighted average based on the number of patient days and costs per program 11 $437 656 465 401 409 340 $401 Communicable Disease Summary Fiscal Year 2002 July 1, 2001- June 30, 2002 Confirmed Cases of Selected Diseases Reported from July 1, 2001 - June 30, 2002 by County of Residence DISEASES Apache Cochise Coconino Gila Graham Greenlee La Paz Maricopa Mohave Navajo Pima Pinal Santa Cruz Yavapai Yuma County Unknown Fiscal 2002 AIDS 1 2 2 0 5 0 2 377 5 5 61 9 1 8 1 2 481 Amebiasis 0 0 2 0 0 0 0 12 0 0 3 1 4 4 1 1 28 Botulism 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Botulism, Infant 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 3 Brucellosis 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 5 Campylobacteriosis 28 12 58 4 5 0 3 349 10 21 138 11 11 32 3 2 687 Chlamydia 389 125 372 113 66 11 36 9240 148 415 2399 363 53 152 406 0 14,288 Cholera 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Coccidioidomycocis 2 8 10 16 5 1 9 2458 31 3 550 97 3 5 13 5 3,216 Colorado Tick Fever 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Cryptosporidiosis 0 0 0 0 1 0 0 13 1 1 1 0 0 0 0 0 17 Dengue 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 E. coli O157:H7 0 1 0 0 1 0 0 18 2 0 3 2 0 1 1 0 29 Ehrlichiosis 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 Encephalitis, SLE 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 Encephalitis, NOS 0 0 1 0 0 0 0 6 0 1 2 0 1 0 0 0 11 Encephalitis, Other 0 0 0 0 0 0 0 6 0 0 0 0 0 2 1 0 9 Giardiasis 1 2 3 10 0 0 1 130 16 1 19 5 1 7 1 2 199 Gonorrhea 49 10 27 8 4 0 2 2822 21 91 527 58 11 6 26 0 3,662 Haemophilus influenzae 7 2 1 0 1 0 0 51 6 5 13 2 0 1 0 0 89 Hantavirus Pulmonary Syndr. 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 Hepatitis A 0 12 4 1 1 0 0 219 8 8 55 11 24 2 24 2 371 Hepatitis B 5 21 15 2 5 0 2 989 24 10 206 42 2 16 31 1 1,371 Hepatitis C 4 71 43 25 48 1 22 2331 172 84 582 420 1 233 65 4 4,106 Hepatitis D 0 0 0 0 0 0 0 2 0 0 0 2 0 0 0 0 4 Hepatitis E 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Hepatitis Non A-B 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 HIV (non AIDS) 3 5 1 0 3 0 1 436 3 1 55 13 0 6 6 0 533 Legionellosis 0 0 1 0 0 0 1 7 1 1 4 0 0 1 0 0 16 Leprosy 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 12 DISEASES Apache Cochise Coconino Gila Graham Greenlee La Paz Maricopa Mohave Navajo Pima Pinal Santa Cruz Yavapai Yuma County Unknown Fiscal 2002 Leptospirosis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Listeriosis 0 0 0 0 0 0 0 9 1 0 2 1 0 0 0 0 13 Lyme Disease 0 0 0 0 0 0 0 4 1 0 0 0 0 0 0 0 5 Malaria 1 0 1 0 0 0 0 13 0 0 2 0 0 0 0 0 17 Measles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 Meningitits - Aseptic 1 2 1 0 0 0 1 197 5 0 4 3 0 3 0 0 217 Meningococcal, Invasive 0 1 0 0 0 0 0 19 0 3 4 1 0 0 1 0 29 Mumps 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 Pertussis 7 0 0 0 0 0 0 102 7 0 15 1 1 2 1 0 136 Plague 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Q Fever 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Relapsing Fever, Tick 0 0 2 0 0 0 0 1 0 0 0 0 0 0 0 0 3 Reye Syndrome 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 Rocky Mountain Spotted Fever 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Rubella 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Congenital Rubella Syndrome 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Salmonellosis 25 15 20 7 4 0 1 409 11 8 147 40 9 19 20 16 751 Salmonella Paratyphi A, B & C 0 0 1 0 1 0 0 5 1 0 3 3 1 0 0 0 15 Shigellosis 11 11 25 3 0 0 0 237 2 7 92 32 8 4 13 3 448 Streptococcus Group A 3 3 11 0 2 0 0 181 7 4 45 14 0 2 0 0 272 Streptococcus Group B 0 1 2 0 0 0 0 28 0 1 3 2 0 0 0 0 37 Streptococcus pneumoniae 22 18 25 4 4 1 0 460 31 18 124 35 3 6 0 2 753 Syphillis P&S 4 0 4 0 1 0 0 155 0 10 30 0 0 0 0 0 204 Syphillis E/L 8 4 4 1 7 0 1 799 1 10 49 51 3 0 13 0 951 Syphillis, Congenital 1 0 0 0 0 0 0 22 0 1 0 1 0 0 1 0 26 Tetanus 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 Toxic Shock Syndrome 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Tuberculosis 12 3 6 1 0 0 0 192 6 6 28 11 3 1 25 0 Tularemia 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 Typhoid Fever 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 Vibrio spp. 0 0 0 0 0 0 0 7 0 0 2 0 0 0 0 0 9 VRE* 5 6 16 13 7 0 3 751 27 16 107 39 0 18 12 3 1,023 Yersiniosis 0 0 0 0 0 0 0 5 0 0 2 0 1 0 0 0 8 294 Source: ADHS Bureau of Epidemiology and Disease Control Services, 06/30/02. Only incident cases are reported. Streptococcus pneumoniae is lab reportable only. Haemophilus influenzae includes all invasive disease caused by Neisseria meningitis, not just meningitis. Haemophilus influenzae, Streptococcus Group A, Streptococcus Group B, and Streptococcus pneumoniae include invasive disease only. Non-resident cases have been excluded. *VRE refers to Vancomycin-resistant Enterococcus. 13 For more information about Arizona Department of Health Services programs, goals, and services, please contact the Public Information Office at 602-542-1001, or visit us on the web at www.hs.state.az.us Janet Napolitano, Governor Catherine R. Eden, Director 1740 West Adams Phoenix, Arizona 85007