July 12, 2010
Host: Ted Simons
- A look at Arizona’s monsoon with Randy Cerveny, director of the meteorology program at ASU.
- Randy Cerveny - Director of Meteorology Program, ASU
| Keywords: weather
Ted Simons: The weekend's monsoon storms missed much of the valley, but as temperatures rise, so do our chances for more storms. Here to talk about the monsoon is Randy Cerveny, a professor of geographical sciences who directs the meteorology program at ASU. Good to see you again. Thank you for joining us. We do this every time, it seems like, this time of year. Monsoon began June 15. Who knew?
Randy Cerveny: That's right. The National Weather Service wanted to change that a few years ago so that the emphasis wasn't on when it started but on getting the safety information out. So by having a set date, they could make sure that the media was given all the appropriate safety instructions to start getting out to the public so that, in the past, the old definition of three days of having a dew point at 55 got people watching too much the dew point and not really what they should be doing, make themselves safe for the monsoon.
Ted Simons: When does the monsoon usually start?
Randy Cerveny: Actually, right around this time. This is the classic start, is the first or second week of July here in Phoenix. It starts a little earlier in Tucson, but we get enough moisture coming up into the area to trigger the thunderstorms that provide the classic monsoon.
Ted Simons: What are you looking at as far as this go around for the monsoon? What are you expecting? Do we know? Can you forecast such a thing?
Randy Cerveny: It is a really tough thing because the problem with a monsoon is it is made up of individual little thunderstorms, and so Cave Creek can get one thunderstorm and Chandler can miss it, and Cave Creek will say it is a great monsoon this year and Chandler will say, no, we didn't get anything. So it is a very localized type of thing.
Ted Simons: It is kind of like what we have been seeing the past couple of days, Apache Hills and Grand Junction got hit, but much further west of there, nothing.
Randy Cerveny: Right, That is usually how the monsoon gets it start, it gradually builds up in the White Mountains and to the north and to the south and encroaches each night a little bit further into the Phoenix, metropolitan area.
Ted Simons: How different are storms today from what the valley -- let's keep it to the valley here, what we saw 25, 45, 75 years ago? Any difference in these storms?
Randy Cerveny: Yeah, the big thing is the lack of the dust storms. The big plumes of dust that we have will occasionally happen, we get one or two maybe a season, but in the past you would get several of those during the course of the monsoon season. In today's world, because we're paving over all that desert dust, we don't get as many dust storms.
Ted Simons: I've often wondered about this, this may be a dumb question but I will ask it anyway. Say we had a monster monsoon, covered most of the state, lots of rain in the desert. Lots of it. The next day can we get a dust storm again if so much rain has fallen over desert area?
Randy Cerveny: The big problem is you generally don't get a storm the next day after a thunderstorm. One night you can get all the mechanics, all the energy available to blow up into a big thunderstorm, but the thunderstorm tends to stabilize out the atmosphere so that the next night is usually a much more calmer situation. However, again, given the localized nature of these storms, yeah, you can have a dust storm appear the night after another dust storm if it doesn't take exactly the same track as the previous night. We've had that happen with storms that have come down off of the rim and then the next night they might come up from the Eloy area and you can have a dust storm coming up.
Ted Simons: But If a desert got swamped in one spot or a general region, it is unlikely the dust would go through there or start there, those sorts of things?
Randy Cerveny: Right, because the dust itself has to be picked up by these winds, and if they've been adhered to by the moisture locking it to the soil, then it is harder for it to get up in the air.
Ted Simons: We've talked about this, you have to have high temperatures, 13, 14, 15, this sort of thing, to draw up that moisture. Can you also have an extended period of time of 108, 109, 110? Does that work the same way or do you have to get the 113 and 14 before things start happening?
Randy Cerveny: Well, it helps to have the really hot air because hot air rises and that tends to be able to act like kind of a suction pump to pull up the moisture from the Gulf of California up through Arizona, so the really hot temperatures are the best. But if you have even like 108, 110 for a prolonged period of time, that's enough energy to draw up the moisture, as well.
Ted Simons: So we don't necessarily have to top out at 115 or 16. If it is long enough, we will get there eventually.
Randy Cerveny: Unfortunately, with that said, the likelihood is on Thursday and Friday of this week we will be up to that range anyway.
Ted Simons: Can you look at winter temperatures, winter weather, spring temperatures, spring weather and say we should have at least a general monsoon of this particular nature?
Randy Cerveny: We have tried. It has not really worked that well. We thought that there was a pretty decent relationship between the amount of snow cover that the United States got in the wintertime and how strong our monsoon has been, but it's not a perfect relationship. Some years it seems to work really well, other years it doesn't. All the indicators that we have looked at seem to suggest that this is going to be a fairly normal to maybe a slightly above normal monsoon season. But we really are not good at predicting the intensity of this thing well in advance yet.
Ted Simons: And it goes along September, those lines?
Randy Cerveny: The technical definition now is September 15 we call it closed. What happens is the monsoon flow starts to merge with dying tropical storms to come up from the Gulf of California and from the Pacific Ocean, and that moisture will sometimes obscure what the true monsoonal moisture is and it gets harder to identify a true end.
Ted Simons: I think I've asked you this before, but the reason that Apache Junction, Cave Creek, Fountain Hills always seem to get the monsoon and Buckeye and Gila Bend are saying I know where it is happening, it's not happening here, why is that?
Randy Cerveny: It's elevation. What happens is that moisture flows uphill and rising air is more likely to create a thunderstorm, so you first see the true indications of a monsoon in places like Apache Junction and Cave Creek because the airflow is coming up from the deserts and flowing up that up-slope area. Central Phoenix and places like Gila Bend and such, they don't get it quite as soon.
Ted Simons: Thank you, Randy, always a pleasure.
Randy Cerveny: My pleasure.
Mental Health Funding
- State funding for the seriously mentally ill has been cut in Arizona. Richard Clarke, CEO of Magellan Health Services of Arizona, and Dr.
Laura Nelson, interim deputy director of the Arizona Department of Health Services/Division of Behavioral Services, will discuss how people with serious mental illnesses will get the help they need after the reduction in funding.
- Richard Clarke - CEO, Magellan Health Services of Arizona
- Dr. Laura Nelson - Interim deputy director, Arizona Department of Health Services/Division of Behavioral Services
| Keywords: mental health
, health care
Ted Simons: At the start of July, state budget cuts began affecting services for thousands of low income Arizonans with serious mental illnesses. Where will they now find the help they need? Here to talk about that are Dr. Laura Nelson, Interim Director of the State Department of Health Services Division of Behavioral Health. And Richard Clarke, CEO of Magellan of Arizona, the state-contracted provider of behavioral health services in Maricopa County. Good to have you both on the show.
Laura Nelson: Thank you.
Ted Simons: Dr. Nelson, the impact of budget cuts on behavioral health services. What are you seeing?
Laura Nelson: It is somewhat early to tell, but as you know, this has been one of the worse budget crisis Arizona has ever seen. We have a decreased 5 to 15% the state general fund revenues for individuals who don't qualify for Medicaid. We have about 14,000 adults with serious mental illness around the state who have seen a tremendous reduction in the benefit package. We've been monitoring very carefully since July 1. So far, we're not seeing any major increase in the use of our crisis services or complaints from our hospital emergency rooms, but we will continue to monitor this very carefully.
Ted Simons: Just so we know, we're talking everything from housing to transportation, crisis services, medication, as well?
Laura Nelson: Exactly. We went from a fiscal budget in 2008 of $127 million for those who don't qualify for Medicaid down to about 62 million. There is about 40 million set aside to help with a medication benefit for adults with serious mental illness and that is about it. They would still have coverage to see their doctors and any necessary blood work they need to get, but no longer have coverage for in-patient stay, residential, case managers, transportation and the like.
Ted Simons: Again, it's been less than two weeks here, but what are you finding from these non-title 19 folks, these folks that don't qualify for access? I mean, they're really in a bind here. Are you hearing anything so far? Seeing anything?
Laura Nelson: One of the strategies we undertook over the last several months, and Dr. Clark can talk a little more about this for Magellan, but statewide we required our regional providers to really reach out individually to all of these 14,000 people and look at what services are you getting today, what is going to happen by July 1 and how can we help you identify other sorts of supports in your community, whether it be family, whether it be friends that kind of thing.
Ted Simons: Is that part of the high-touch transition plan I've been reading about?
Richard Clarke: We're talking about thousands of individual lives of people who are struggling daily with the challenges of a serious mental illness, adults, and the children's arena there are about 2,000 children who are in the same situation of losing their potential benefits that they had. So we developed a system called a high-touch, high relationship, and we felt it was our responsibility with the provider system to touch every single individual by hand and work through an individualized transition plan for them. So whatever services they were getting now, what their new benefit package was and walk through with them all the treatment planning options for them. And not to let go of their hand until such time as that every single person had a plan in place that we felt was safe and clinically sound.
Ted Simons: It sounds logistically daunting. Again, less than two weeks into this, what are you seeing?
Richard Clarke: We started this process in April in anticipation of the budget cuts and there was kind of a three-stage process that happened. We went out and met with all 25 clinic advisory councils that are run by recipients and met with family members and community members and staff and talked with them about the kind of changes that were going to be coming down so they were anticipating them and they could begin to prepare with us. We met with all the peer services organization, we held a series of resource fairs across Maricopa County to prepare people to begin to think about what the resources were that were available to people. And because working with the department and together we had this vision to transition people in a safe, clinical way, we were not in a position where we were going to be abandoning anybody the first of July, so some people are still transitioning. I think some good policy decisions were made by the department to allow for a 90-day transition from brand name medications to generic medications for the majority of individuals, which means we're still working through some of that with individuals so they're still getting a level of support they had prior. Other individuals we're working on their housing, so as we work through the housing issues, we won't let their transition plan go until they're fully secured in a safe, independent or supported housing environment. And as a result of that, we're seeing a system right now that is kind of stable, and we're going to continue to monitor it. We have a team of 12 individuals working with about 200 providers in the community. We meet every day at 4:00 in the afternoon, we assess the system with our crisis providers. Dr. Nelson and I communicate about what the status of the system is and we're going to continue to monitor that.
Ted Simons: Things like clinical care, making that transition, what is involved, challenges there?
Laura Nelson: Many of these individuals are used to having a case manager. They can call their clinic and ask to speak to a particular individual, and that individual will kind of help them navigate in the system. And without having case managers available, this responsibility is falling on physicians in the clinic, nurses in the clinics and other sorts of additional staff that we've tried to put in place to help field those calls and respond to some of these questions coming in. As we were just talking a minute ago, one of the biggest challenges where we've heard the most concern from the community has not been about in-patient or residential, it has really been about the medications. Many folks have been on brand name medications which are extremely costly and don't yet have a generic alternative and we have, at this point, indicated that you can have an additional 90 days to transition to the generic medications. But until we get a better sense of how far this $40 million is going to go that has to last the entire year, we're reluctant to keep that formulary open for the brand name medications.
Ted Simons: That of course includes suicide prevention ideas as well, is that transition going to work? What are we seeing out there?
Richard Clarke: We have a very robust system, and we have across the state and with the department, we have a system that really is centered around the client and the patient, and I think that kind of support is really helpful. But it's important that we do a number of things to keep the system moving in the right direction. It is one of the things that we've developed, as Magellan of Arizona, is a training program called the helpers. In a system like this where Dr. Nelson is saying most of the individuals are losing their case manager, their families and their friends are going to take on more of that kind of responsibility, so we're training people on how to be the role of a helper in a situation like this. We've developed a community partnership program, which is developing a volunteer corp for hot lines and warm lines and individuals who are interested in helping people get transportation to go to their medication visits. We've also funded in Maricopa County to what we call physician extenders, clinical case managers to work with the doctors and the nurses for the individuals who are transitioning on their benefits so that there is some connection there, even though it is not the same case manager, there is still a connection for them to get to their appointments and schedule their appointments. I think what we've -- as a system, I think we've been really proud of, is with the department we've been really focusing on transforming the system into interventions that are sort of state of the art, so in Maricopa we have a nationally-recognized suicide prevention initiative and we're training 2500 practitioners in Mericopa County with how to be with people in their pain and create intervention opportunities to reduce the rate of suicide. We're changing the clinical care management model. We're looking at crisis planning alternatives. We're building out a whole expansion service, so while we've lost a significant number of dollars as it relates to the non-titled individuals, our system is growing and we will continue to fill the gaps in to keep the system moving in the right direction. That gives people a sense we have a system that cares about them and cares about the services we will deliver.
Ted Simons: Last question, quickly, someone with a serious mental illness, someone has a family member in that condition and with those conditions, what do they need to know right now?
Laura Nelson: They need to know there is help in their community, there is help at the department of health services. We have an active website we continue to update, www.azdhs.gov/bhs for behavioral health services and we're providing answers to frequently-asked questions every day and we have customer service available. I would also like to point out one highlight we've seen as a by-product of the last few months is consumers and family members and advocates from across the state are stepping up and pulling together to help each other. There is the development of a consumer and family coalition that meets out of our agency now that has consumers from around the state that are wanting to be a part of the solution as we struggle with this.
Ted Simons: Very good. Thank you both for joining us tonight. We appreciate it.
Richard Clarke: Thank you, Ted.
- Among the five largest domestic airlines, US Airways came in first during the month of May in on-time performance, baggage handling and fewest customer complaints. US Airways Chief Operating Officer Robert Isom talks about the progress the company is making.
- Robert Isom - Chief Operating Officer, US Airways
| Keywords: us airways
Ted Simons: Good evening and welcome to "Horizon." I'm Ted Simons. May was a pretty good month for U.S. Airways. That's according to a July report from the Department of Transportation. Among the five largest domestic airlines, U.S. Airways was first in on-time performance, baggage handling and customer satisfaction. Here to talk about that and other airline news is Robert Isom, Chief Operating Officer for U.S. Airways. Good to have you here, thank you for joining us.
Robert Isom: Thanks, Ted, appreciate it.
Ted Simons: That is a pretty impressive turn around. What happened?
Robert Isom: It is fantastic. It is just one month.
Ted Simons: Right.
Robert Isom: But every measure that the D.O.T. takes statistics on, we came in number one among the big network carriers. All 31,000 employees of U.S. Airways are really behind it, and it comes from a few years back when we ranked dead last in just about every measure to today we're number one. And it has really been a combination of getting flights out on time, really making sure that we do the right thing with baggage. What things don't go right, making sure we recover with passengers.
Ted Simons: Take those one at a time.
Robert Isom: Sure.
Ted Simons: Getting flights out on time. It sounds like there is a new idea which is get the first ones out on time and the rest will follow.
Robert Isom: Ted, that is exactly right. When you take a look at it, no matter what party you're dealing with in the airline, whether it is customers or employees, if the flight gets out on time in the beginning of the day, has a better chance to make it through the entire day on time. Which means first off passengers get to where they want to go, it is easier to connect back, and for our employees it really makes for a much more enjoyable day for them.
Ted Simons: Was it an increased focus on getting the earlier flights out? I imagine before the idea was to get the flights out on time.
Robert Isom: It has always been there but having the resources ready to go with the same goal, which means departure out on time, not five seconds later or 10 seconds later but on time is the key, and auditing and training to make sure the flights get out on time.
Ted Simons: You mentioned baggage handling there. Good scores there. There is some sort of scanner plan in effect? What is going on there?
Robert Isom: With almost 95% of our bags now, we're scanning at just about every point of contact so on to airplanes, off of aircraft and sometimes in baggage rooms and it has really done a tremendous amount of good for us in being able to track bags and identify issues to make sure we're doing things right.
Ted Simons: So not only getting the things on the plane, but if a mistake happens, knowing where they are.
Robert Isom: Exactly. With the scanner, say you're on the line in Phoenix and you come across a bag that you're scanning on to a flight, and if it is not supposed to be on that flight, there will be a beep that tells you, hey, it's not supposed to be on that flight, put it on another flight, or rather the right flight.
Ted Simons: Never good to hear a beep.
Robert Isom: Exactly. Never.
Ted Simons: Fewest complaints. Number one in fewest complaints. Again, from what I understand, a new tracking system, an I.T. kind of thing?
Robert Isom: New tracking. It really goes back to a few years ago when we said, hey, look, we really want to get customer feedback in the hands of people that can do something about it, so identifying problems in the system no matter where they are, and creating actionable information to address customer issues, not only for that specific customer but for the next one to make sure whatever happened we do it right in the future.
Ted Simons: Managing expectations a big part of that.
Robert Isom: Managing expectations and certainly doing a lot of work to follow-up on any issues, so we put in place measurements in just about every aspect of the operation and audited really just about every measurement, as well.
Ted Simons: These changes we talked about, were they slow to come around because of merger issues? What was going on here in how come we're not hearing about this earlier in.
Robert Isom: No, it is not about merger issues, it is about getting everybody aligned and heading in the right direction. We did that back in 2007, first trying to get flights on time and taking that message further to reliability, convenience and really focusing on our appearance, making sure aircraft are clean and people are presenting themselves in the right way.
Ted Simons: Something as simple as that makes a difference.
Robert Isom: It makes a difference, especially when you put a strategy around it all, roll it out, have everybody behind it and day in and day out executing against it.
Ted Simons: As far as employees are concerned, bonus programs, I hear they're in effect. How much do they help?
Robert Isom: We have a triple play program, somewhat based off of baseball, but what it measures is first place rankings in any of the D.O.T. categories, the three, and we've had pretty good success, paying out $50 to each employee for a number one ranking in those measures. This year, we paid off in April, and then you know, with the three times, in May. Just fantastic work. And so over the last couple of years, we've paid out a considerable sum of money, well over $1,000 to every employee in the company.
Ted Simons: I hate to put a cloud over the parade, but I saw another survey regarding frequent fliers. U.s. Air didn't do as well with terms of services and availability for frequent fliers. What is going on there?
Robert Isom: Frequent fliers, we're very interested in what they have to say to us, so we track as well as anybody does what's going on. And for the most part, our frequent fliers tell us what they really find important, and one of the big things they find important is the ability to upgrade and we do better than most airlines and that's a really important measure. You combine that with what we do with clubs, combine that with what we're doing with overall reliability, we fare pretty well.
Ted Simons: A good month, how do you make sure you have another good month and another one and another one. How do you keep this going?
Robert Isom: You're only as good as the last flight, and when you're handling hundreds of thousands of passengers a day, it doesn't take much to have somebody that is not pleased with you. What we do is making this a part of our culture, institutionalizing departing on time, institutionalizing being the best at recovering when things don't go right, and putting in place the systems and all the people around that.
Ted Simons: So can this be done when -- I'm not even in the business and I'm hearing about merger rumors. The folks that work for your airline, they must be hearing about this. How do you keep morale up, and what do you know about a merger rumor? What is going on?
Robert Isom: Ted, as you know, we don't comment in terms of the way we run the business, we have been advocates, actually with the merger of America West and U.S. Airways, real sponsors of mergers and consolidation in the industry, but to our employees it’s running the business the same way whether there is that kind of rumor out there or not. The best thing we can do is service our customers, make sure they get the product they paid for day in and day out.
Ted Simons: Good to have you here. Thank you for joining us.
Robert Isom: Ted, thank you very much. Great to be here.