PUBLIC MENTAL-HEALTH SYSTEMS, MEDICAID RESTRUCTURING AND MANAGED BEHAVIORAL HEALTH-CARE

This paper is a working document developed during a time of major chan ge in public mental healthcare, including the States' movement toward managed care. Leaders in both the public and private sector see opport unities and threats presented by public-private collaboration in menta l health system reform and are interested in contributing to new model s of integration which preserve the best of the public system but chal lenge the field to combine social mission with good business practice. The purpose of this paper is to suggest guidelines for public payers' move toward managed care in order to improve practice, to reduce conf lict and litigation and, most importantly, to support quality and effi cient mental health services. Developed by the American Managed Behavi oral Healthcare Association and the National Association of State Ment al Health Program Directors, this document is very much a ''work in pr ogress'' which reflects the developing issues and concerns in public s ector managed behavioral healthcare. Both associations consider the do cument open for additional comments and revision. Further, this paper is not intended to represent a set of prescriptive standards to absolu tely govern behavior, but rather to articulate ''best practice'' in an area that is being defined day by day as public payers privatize sign ificantly larger portions of the public mental health system. It is in tended to highlight general guidelines on how the public and private b ehavioral healthcare industry can move forward in support of high-qual ity, consumer-responsive services.