State health care reforms: How they affect children and adolescents with emotional disorders and their families |
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Authors: | Beth A Stroul MEd Sheila A Pires MPA Linda Roebuck MSSW Robert M Friedman PhD Beth Barrett MA Kristina L Chambers BA Mary Ann Kershaw BS |
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Institution: | (1) National Technical Assistance Center for Children's Mental Health, Georgetown University, 6725 Curran Street, 22101 McLean, VA;(2) Human Service Collaborative, Washington, DC;(3) Missouri Department of Mental Health, Springfield, MO;(4) Department of Child and Family Studies, Florida Mental Health Institute, Tampa, FL |
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Abstract: | This article reports on the Health Care Reform Tracking Project, a national study designed to describe and analyze state health
care reforms and their impact on children and adolescents with emotional disorders and their families. It summarizes the results
of the baseline survey of states conducted in 1995, exploring the nature and extent of the reforms in which states are engaged,
most of which involve applying managed care technologies to their Medicaid programs. Trends across states are identified with
respect to mental health service delivery, particularly with respect to children and adolescents. The article concludes with
a discussion of issues and concerns related not only to mental health service delivery for children and adolescents with emotional
disorders and their families but also to the systems of care that have been developing over the past decade to serve them.
Some of these concerns include the lack of pilots or demonstrations, limited mental health coverage in some reforms, the lack
of integration between mental health and substance abuse systems, the lack of special provisions for children, the need for
more reliable bases for deriving capitation rates, the limited incorporation of systems of care, the need to incorporate interagency
treatment planning and service delivery approaches, the lack of outcome measures specific to and appropriate for children,
and the need for greater family involvement in the planning and implementation of these reforms. |
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