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C3 Progress Event - Roundtable Discussion Guide & Notes

Livable Wage

The livable wage is a major concern highlighted. The pay difference between general healthcare and behavioral healthcare providers significantly impacts provider engagement, retention, and the consistency of care. This gap adds to the workforce shortage. Despite mentions in acts like the Mental Health Parity and Addiction Equity Act (MHPAEA) and the Affordable Care Act, pay parity is not clearly defined.


  1. What creates wage parity?
  2. Which organizations focus on backing wage parity? How can we join forces to advocate in one voice?
  3. What partnerships can advance this work?
  4. How can we involve AHCCCS in our efforts?

Recap of Small Groups

  • It’s difficult to compete in today’s climate – it’s not just about healthcare.  People are leaving BH for better pay. We are competing for jobs against large corporations.
  • Lower pay is a result of stigma.
    • We need to better show the value of the work. Workers need more support.
    • Explore marketing strategies to convey the value of BH staff.
      • Get data to our state legislature.
      • What is most successful for BH and how can we use this data to drive wages, increase VBP, etc.
      • Get better at telling a story – this includes data on all BH interventions.
    • Pay is tied to how people view the importance of the work being done. When pay is low, the stigma is often that the work is less valuable.
  • Explore and make available other options.
    • It’s not just the money – it is also job/task parity. We have too many cases and not enough time to do the tasks.
    • People want chances for growth.
    • Employers need to focus on serving. Servant leadership.
    • Consider the overall comp package.
      • Consider other types of benefits and discounts that can balance out the comp package.
    • Consider how culture impacts priorities and equity.
    • Different communities vary in needs.
      • Regional awareness
        • Housing benefit may prompt someone to work for an employer in a community with housing shortages.
  • If we want folks to invest time and education to work in the field, it has to balance out.
  • Leverage public-private partnerships. We need private funds as well as Medicaid funds.
  • ASU published a paper with recommendations:
    • Establish a study committee at the legislative level
    • Explore equitable reimbursement rates
  • If rates go up, we must make sure that money gets to the people doing the work via increased salaries.
  • Education and billing issues:
    • Doctors spend the least amount of time with people but bill the highest rates.
    • Focus on individuals with highest education spending time with those with the highest acuity.
  • The AZ Council has a group focused on wage parity . They have worked on this for the past 8 years and have a good lobbyist.
  • Look at what other states are doing.
  • The recent fraud and abuse changed wage parity.
  • Find other sectors that profit from folks using services. Get these industries to help lobby.
  • How are rates set? Is it based on the people served? Public vs. private?
  • General medicine serves all folks. Sometimes people see BH as only serving a sub-set.
  • Create a task force focused on this.
    • Need to include AHCCCS.
    • Include NAMI, Goodwill, and others

Broadscale Marketing Campaign to Reduce Stigma

The C3 Action Plan emphasizes anti-stigma efforts, including marketing campaigns. Ideas from the C3 Action Event involve using Mental Health First Aid and other anti-stigma trainings into onboarding for employees in non-healthcare businesses. Developing an ad campaign is also a goal.


  1. Which non-healthcare/social service businesses should be the focus for mental health training during employee onboarding?
  2. How can we present this idea to businesses outside of healthcare?
  3. What connections can assist with this? What role can your organization play?
  4. Which community orgs are key to an impactful marketing campaign?
  5. How do we fund an ad campaign?

Recap of Small Groups

  • Stop separating behavioral health, physical health, and other disabilities. Celebrate diversity and its intersections. Recognize that these are all part of the diversity of humankind.
  • Messaging should display that everyone has a spectrum of behavioral health needs.
  • Target people with more stigma and/or are less likely to seek help. Develop targeted outreach to older males. Market at sporting events, using athletes as spokespersons, and connecting with team related media events.
  • Teach the public the importance of BH assessments for preventive care. This is just as important as standard physical health preventive care such as a prostate exam.
  • Social media influencers are self-disclosing and gaining many followers. They share their personal journeys.
    • How can we use this to impact more people?
  • Look at social media engines focused on stigma reduction – how do we amplify this?
  • We must consider how to reach those who do not have social media and those in a rural locale.
  • School units focused on youth and mental health are impactful.
    • Expand this approach to outreach to parents. This should include strategies to reach parents of children not yet in school.
    • Offer resources to the youth.
  • Narcan training for other sectors. This offers a way to teach and start a dialog.
  • Engage neighborhood groups. The neighborhood improves when BH resources in it. Tucson groups to engage include 4th Avenue Merchant Group, Living Streets Alliance, local neighborhood associations, etc.
  • Partner with a marketing agency.
  • Collaborate with non-healthcare industry
    • Invite non-industry partners to learn about what we are doing.
    • Everyone knows someone facing BH needs.
    • Consider how Community Health Workers and Peer Support Specialists can be embedded into these non-industry partners.
  • Stigma training is influenced by power structures within an industry, SDOH, etc. with focus on creating a safe place within a given business/industry.
  • Find athletes and business leaders to share their stories.
  • Pima County Health Department has a new grant focused on reducing stigma. C3 gives us the opportunity to learn from each other and connect. Learning about efforts such as the Pima County Health Department grant enables us to support each other.

Approach, Time & Availability

Effective teamwork is crucial for addressing community-wide issues. Finding efficient ways to work together while respecting time constraints is essential.


  1. How can we advance this work and encourage partnership while respecting time and availability?
  2. What might future events look like?
  3. How can we ensure that C3 goals reach the entire community and impact public policy, state plans, etc.? Can elements integrate into agency plans?

Recap of Small Groups

  • Keep momentum.
  • Refine workgroup approach.
    • Ensure meetings include targeted discussions, clear plan, and clear purpose.
    • Publicize workgroups and how new partners can get involved. People did not know about the workgroups.
    • Create clear roles for groups:
      • Time commitment
      • Group point person
      • Define individuals’ roles
      • Define a group action plan
    • Frequency of workgroups can be a problem. Quarterly meetings are better than monthly. What can be achieved by email rather than meeting?
    • Talk about the progress and success of a given workgroup to keep folks engaged and feeling good about their time and impact.
    • Consider combining workgroups to streamline efforts and avoid duplication.
  • Hybrid meetings are good and inclusive. People don’t want to lose the in-person element. Consider increasing in-person meetings to quarterly.
    • Don’t just offer in-person meetings in major cities. Rotate locations while increasing frequency of the large meetings.
    • In-person is powerful and should not be lost.
  • Partner spotlights are moving and a key part of C3. Creating the chance for partners to learn from one another has a huge impact.
    • Many agencies have C3 elements in their current organizational plans. C3 offers the platform for agencies to learn from one another, talk about how to scale things, etc.
    • Partners can consider formal collabs (like an ACO type model) to help scale and keep goals over the years.
    • Provider potlucks may be a tool to keep such collaborations.
  • Targeted outreach to engage additional leaders in C3: AHCCCS, legislators and politicians, AZ Hospital Association, physicians’ orgs, foundations, and more.
  • Reconnect with current and past partners. C3 can be a tool to boost awareness of what is happening and how we can support.