Flexible system allows new services to crop up

Managed care can mean more service

A recent report by the Institute of Medicine in Washington, DC, strongly criticized managed care plans for limiting the services available to Americans who need behavioral health care. But the Colorado Department of Human Services in Denver found that its pilot Medicaid mental health managed care program actually allowed mental health agencies to expand existing services and develop new ones.

"The flexibility of the capitated system allowed agencies to develop new services, such as residential services and respite care, that were not previously available under the fee-for-service system," says Tom Barrett, PhD, director of Colorado Mental Health Services in Denver.

"Under the capitated system, the agencies have the ability to spend the money as they see a need to better serve their clients. Most people view managed care as a way to reduce costs or services, but we look at it as a way to improve services," he adds. (For more information about the Medicaid managed care pilot program, see p. 104.)

New services implemented under the Medicaid mental health managed care pilot program include:

Children’s Acute Treatment Unit.

This is an eight-bed residential child care facility that serves children ages four to 14.

The Carson Center.

This is a children’s day-treatment program serving children ages five to 12 with serious emotional and/or behavioral problems.

Specialized Services Program.

This program provides a continuum of treatment modalities for patients over age 18 who need acute or long-term inpatient services. Patients are evaluated by an interdisciplinary team of professionals and paraprofessionals and then placed in one of three tracks: partial hospitalization, intensive outpatient treatment, or outpatient services.

The Oasis Home.

This is a family crisis/respite care home that provides short-term care for children and adolescents with the goal of returning them to their homes within a two-week period.

Adult Crisis Homes.

These homes are an alternative to inpatient treatment for adults with major mental illness. These homes also are used as a transition from inpatient treatment back into the community.

Supportive Employment Program.

This program provides employment coaching, development, and placement, as well as job-seeking skills and other assistance to patients and local employers.

In-Home Respite Program.

This program provides emergency and planned respite support for parents to stabilize families in crisis.

Inn Between.

This is an eight-bed community-based residential program for adults.

Rapid Response Team.

This team includes six therapists and provides emergency evaluations and time-limited outpatient and case management services to children and adolescents.