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Transforming service transitions, one hero at a time

June 27, 2013
by Lori A. Ashcraft
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'You know heroes like these. Without these unsung individuals, everything around us would fall apart . . .'

All of us are inspired by the story of a hero, someone who does something that seems great to all of us but that often seems more or less obvious to them. Though we love to talk about heroes, many of us aren’t very good at recognizing them. As a result, there are a lot of heroes out there that never get talked about. But these would-be heroes don’t seem worried about it. Their work is usually low-key;  they fly “below the radar” most of the time.

Transitional experiences tend to bring out the worst in many of us. When we’re confronted with major changes, our insecurities surface and we can succumb to the temptation of playing dirty, acting out of fear, blaming others, or rigging things so we look better than anyone else. Ew! But heroes don’t do that. They’re the ones who always do their part, continuing to deliver over long periods of time no matter how crazy things get, or keeping their heads even during harrowing periods of change. They do this whether they are recognized or not.

You know heroes like these.  Without these unsung individuals, everything around us would fall apart sooner or later.  

In Maricopa County, better known as Phoenix, Arizona, behavioral healthcare providers and those we serve are enduring yet another harrowing period of change as the battle over which organization will actually run our regional behavioral health authority churns on. Many of these providers are heroes, people who continue to deliver services as two larger organizations, the incumbent Magellan and the would-be contract holder, Mercy Care, continue to jockey for position, hoping to come out on top when the dust finally settles.

Events like these are hardly unique to Maricopa County.  Personally, I’ve been through so many of these transitions that I don’t even blink anymore. All the while, both the unsung heroes and the contending business interests continue to do what they must, or what they should. We all know who these characters are and we accept them as part of the unfolding drama of the process.

It wasn’t always this way for me.  I fell in with the insecure during my first Maricopa transition. I moved here in the spring of 1995, accepting the position of Director of Adult Services for ComCare, the nonprofit organization that held the contract for Maricopa County’s Regional Behavioral Health Authority with the State of Arizona’s Department of Behavioral Health. I had lived and worked in California most of my life and this was a big move for me. It didn’t take me long to warm up in Arizona, but I also quickly warmed up to Arizona. I discovered that there was a lot of openness to creating new solutions and innovative approaches for service delivery.

I was happy with my decision to move. I loaded up my three dogs and drove my little car to Phoenix. I bought a house within walking distance of a park, just a few blocks from the ComCare offices. Of course, I had no way of knowing then that ComCare would lose the RBHA contract less than two years later through a series of unprecedented and unusual events. Thus began a long series of changes and transitions in behavioral health oversight and leadership for the communities located in Maricopa County, a transition that continues.

I now consider myself a survivor, a veteran of transitions, with the ComCare shutdown being the first. The state took over the business for about a year, then awarded the contract to ValueOptions. The next transition was from ValueOptions to Magellan, and now Magellan appears to be on its way out while Mercy Care appears to be coming in (pending litigation). Constant transitions are more the norm than the exception.

Let’s get back to those unsung heroes, those grown-ups that don’t sink to the level of either just meeting the minimum requirements or looking good at the expense of others during transitions. How is it that they can remain so mature, so generous, and so centered during all this confusion? How is it that they don’t just survive, but thrive, during the chaos?

I don’t need to do a lot of in-depth research to answer these questions. I only have to look around me and within me to see and feel the inclinations that cause me to react from a mindset of fear and insecurity instead of opportunity and generosity. Yes, I have those inclinations too. How else would I know so much about them? I can tell you that they seem to have their roots in the drive to compete, to survive.  God knows, we have all been set up to compete with each other for funding. There is only so much to go around and if I get more, you get less, and vise versa. We’ve been conditioned to compete with each in a win/lose game of survival, yet, there are those who don’t get sucked in to playing this game. They are the heroes!

The transition we are experiencing now may prove to be the most prolonged and complicated change yet seen in Maricopa County. However, this extended period provides us with lots of opportunities for self examination, as well as the chance to practice the positive things we’ve learned from enduring earlier transitions.

So how can we, the providers, the people receiving services, the leaders and decision makers, the attorneys and the budgeteers, come out of this experience being the wiser, the more mature, the more effective for it?  I’ve got a few ideas:

·         We need to trust ourselves more. We need to know that what we have to offer is valuable and that if it isn’t valued in one place, we can adapt it to make it so or take it to a place where it will be valued. 

·         We need to develop and maintain a healthy respect for each other, in part by valuing what others bring to the table.

·         We need to learn how to partner instead of compete, so our work need not always be a win/lose proposition.