State Men­tal Health Ser­vice Fund­ing

Pub­lic men­tal health ser­vices are shaped by mul­ti­ple sources of fund­ing. The two pri­ma­ry sources of fund­ing are Med­ic­aid and state gen­er­al fund dol­lars, which on aver­age fund 90 per­cent of the sys­tem. How­ev­er, 10 per­cent of the sys­tem is fund­ed by Medicare, fed­er­al men­tal health ser­vices block grant funds and coun­ty as well as munic­i­pal funds. For youth fac­ing seri­ous men­tal health con­di­tions, fund­ing for ser­vices may also be pro­vid­ed by oth­er sources, includ­ing schools and the State Children’s Health Insur­ance Pro­gram (S-CHIP). (To read more click on the link below)

What Is Man­aged Care? 

Man­aged care is an approach to financ­ing and deliv­er­ing health care that seeks to con­trol costs and ensure or improve qual­i­ty of care through a vari­ety of meth­ods, includ­ing provider net­work man­age­ment, uti­liza­tion man­age­ment and qual­i­ty assur­ance.  His­tor­i­cal­ly, Med­ic­aid ser­vices for dis­abled ben­e­fi­cia­ries, includ­ing men­tal health ser­vices, have been pro­vid­ed on a fee-for-ser­vice basis where providers are paid for each bill­able ser­vice pro­vid­ed. In con­trast, man­aged care Med­ic­aid pro­grams pay for some or all ser­vices at a pre­paid rate, often based on enroll­ment. (To read more click on the link below)

What to Ask: A Check­list for Advo­cates

Man­aged care is an approach to financ­ing and deliv­er­ing health care that attempts to con­trol costs and ensure or improve qual­i­ty of care. Increas­ing­ly, states are look­ing to man­aged care as a strat­e­gy to con­tain the cost of men­tal health care in Med­ic­aid pro­grams. Man­aged care ranges from Pri­ma­ry Care Case Man­age­ment (PCCM) mod­els that pro­vide pay­ments for case man­age­ment and care coor­di­na­tion ser­vices, while financ­ing most oth­er ser­vices on a fee-for-ser­vice (FFS) basis, to full-risk cap­i­tat­ed mod­els.  This check­list is intend­ed as a first step to help advo­cates ask the right ques­tions and request per­ti­nent infor­ma­tion, par­tic­u­lar­ly for full or par­tial-risk man­aged care plans.  (To read more click on the link below)

Observations/ Rec­om­men­da­tions  Man­aged Care and Com­mu­ni­ty Men­tal Health Sys­tems of Care

For decades, the phi­los­o­phy of com­mu­ni­ty-based sys­tems of care has guid­ed the deliv­ery of men­tal health ser­vices for indi­vid­u­als served by pub­licly fund­ed agen­cies.  This phi­los­o­phy sup­ports sys­tem attrib­ut­es that include a broad array of ser­vices; inter­a­gency col­lab­o­ra­tion; treat­ment in the least-restric­tive set­ting; indi­vid­u­al­ized ser­vices; fam­i­ly and con­sumer involve­ment; and ser­vices respon­sive to the needs of diverse eth­nic and racial pop­u­la­tions. The notion of sys­tems of care emerged in an era when man­aged health care also was gain­ing pop­u­lar­i­ty. How­ev­er, the effect of man­aged care on the deliv­ery of com­mu­ni­ty men­tal health and sub­stance-abuse services—also known as behav­ioral health services—has not been wide­ly stud­ied.  (To read more click on the link below)

Man­aged Care Doc­u­ments

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