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Arizona lawmakers can't agree on mental health legislation. Here's why

There’s a renewed effort this year in the Arizona Legislature to get bipartisan buy-in on mental health legislation. And, that effort seems to be working — at least so far.

Observers say there could be several reasons for that, including the number of people experiencing homelessness and the growing group of so-called Mad Moms gathering at the capitol to tell their stories.

Former state Sen. Nancy Barto often worked on these kinds of bills when she was in the Legislature. She’s still paying attention to them now that she’s no longer in state government, and she spoke The Show about why it’s so difficult to forge consensus and pass bills in this area.

Full interview

NANCY BARTO: You know, to your point about my focus on, on those with serious mental illness in particular, I focused on a lot of vulnerable populations and protecting them and the services that they receive through government. And it just seems like when you're trying to hold providers accountable for the services that they're getting a lot of money to provide, it's always hard whether it's this population or others, I think we have ignored this population for so long.

So in that sense, I think that might be the answer. It's been ignored. They've done things the same way for so long. It's an entrenched power structure in how we've dealt with those with serious mental illness or not treated them properly. So now we're turning, turning things around on their head and it's taking a lot of effort to even get people to understand that there is a problem.

MARK BRODIE: So when you look at some of the, the bills, some of the ideas that are being discussed in the Legislature this session, what goes through your mind when you look at some of the, some of the ideas, some of the proposals out there.

BARTO: Oh, they're creative. They are bipartisan, they're right on point and they're incremental in a lot of sense. There's some big ones that take on large issues and there's some small ones that deal with very specific detailed problems that fix those. So, I'm encouraged.

BRODIE: Well, so let me ask you about one idea and this is something that has been around for quite a while at the Capitol and that is separating the oversight of the Arizona State Hospital away from the Arizona Department of Health Services and giving it its own oversight board. This is something that came up last year. It's been discussed before, you know, many times before. I'm curious what you think is the best way to do that, to get the state hospital out from oversight of the state Department of Health Services. Like what, what's the best way to make sure that the oversight that it needs is what that facility is going to get?

BARTO: Well, I don't know the best way in the long run but I do know that starting with separating it from the fox guarding the hen house has got to be a first step. Whether we end up with full privatization at some point and move towards that in the, you know, in the, in the future, that might be the best, you know, looking onward. But it's got to start somewhere like we have considered a lesser solutions over the years, but nothing is changing that for the better. And so this has to happen in order to start positive change at the hospital, we've got to have independent governance and people that are not affiliated with the hospital, running it and regulating it. 

BRODIE: I'm curious about another issue that I know is important to you and something that you've, you've been paying attention to and that is the the issue of secure residential facilities for, for folks with a serious mental illnesses. Are you seeing movement on that this year? That that is giving you hope that that something could happen on this.

BARTO: It's a huge part of this whole discussion because not everybody who, who needs high level treatment belongs at the state hospital. We've got to have levels of facilities that are appropriate to the individual. So yes, it's a big part of the discussion always. I think every time one of these bills comes up that is mentioned as part of the solution, at least I, I hope it is. And there is a bill and there's you know, to fix some of the some of this lag time on getting those RFPs out which precipitated that money being swept last year. It's gonna be a budget issue. But I think, I think the members can make the case that it's money were spent that's gonna bear fruit in the long run. Save, save money in the long run.

BRODIE: Is this the kind of thing where new facilities would have to be built from the ground up? Or are there, are there existing buildings that could potentially be retrofitted to give a place for, for folks who need treatment and need therapy to, to be before they can, you know, sort of be safe to themselves and others to, to let out.

BARTO: However they decide to do it would be fine. I do think that buildings can easily be retrofitted. All they need to do is increase the reimbursement and those providers will be quite incentivized, to do that work and get those buildings ready, those facilities ready to care for those individuals. 

BRODIE: Do you have a sense of how much money this would cost. I mean, as you know, I mean, you've worked on budgets. I know that you, you are aware of the fact that the state is not in the world's greatest financial situation at the moment. Do you have a sense of how much money this might take?

BARTO: People are creative when there's when there's reimbursement funding to care for individuals that need this level of care. The the real estate market is in flux right now. We've, we've had a huge change in, in how people work and there's a lot of empty buildings, there's health care facilities everywhere you can imagine. So I, I just don't see that as, as a, as a real barrier. The will to get it done is the barrier and understanding of the need is also a barrier. 

BRODIE: So you used the word incremental a little earlier to describe some of what you're seeing at, at the Legislature. I'm wondering if in your mind that is the best and maybe the only way to take on an issue like this is to do it step by step as opposed to doing really big things all at once.

BARTO: Well, yeah, I, I think, you know, every time you're, you're dealing with an issue like that, it's always gonna be incremental in the sense that you've got a separate bill for this and a separate bill for that. So, I think we've done a lot over the last few years that have been incremental and they're just continuing to find ways to address some of the other needs incrementally. But you can't, I don't know if you can, you know, compare them on a scale necessarily as, as to importance.

But yeah, I mean, ash governance is a big one and so is building facilities. So, you know, those have to come at some point, you can't just work around the edges forever without dealing with, with the elephant in the room. And where, where are you going to house people or because, you know, the goal is to keep them safe, the goal is to get them treatment and not to incarcerate them. The goal is really to solve the problem and so all of them work together.

BRODIE: All right, that is former state Sen. Nancy Barto. Sen. Barto, thank you very much for your time. I do appreciate it.

BARTO: You're welcome.

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Mark Brodie is a co-host of The Show, KJZZ’s locally produced news magazine. Since starting at KJZZ in 2002, Brodie has been a host, reporter and producer, including several years covering the Arizona Legislature, based at the Capitol.