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Administration of Mental Health Services by Medicaid Agencies

Administration of Mental Health Services by Medicaid Agencies

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II. National Overview:OrganizationalStructure, Funding,Providers, and DataThis chapter provides a national overview <strong>of</strong> how State <strong>Medicaid</strong>agencies administer <strong>Medicaid</strong>-funded mental health services, focusingspecifically on organizational structure, funding, services, providers,managed care, and data sharing and reporting. Chapter III describesways in which <strong>Medicaid</strong> agencies interact with mental health and other Stateagencies in administering <strong>Medicaid</strong>-funded mental health services and developingpolicy. The tables provide State-level detail from the survey on theseissues, and the graphs highlight some national patterns. Issues highlighted<strong>by</strong> interviewees in response to open-ended questions, such as the impact <strong>of</strong>reorganizations, are also discussed.A. Organizational Structure must be covered <strong>by</strong> <strong>Medicaid</strong> and which servicesmay and must be covered. States are1. Backgroundrequired to cover a core set <strong>of</strong> medical servica.State <strong>Medicaid</strong> <strong>Agencies</strong> es for all <strong>Medicaid</strong> beneficiaries, such as phy-<strong>Medicaid</strong> Program Overview. The <strong>Medicaid</strong> sician visits, inpatient and outpatient hospitalprogram is a joint Federal-State program that services, and certain screening services forprovides health care to low-income Ameri- children. States have the option to covercans in all 50 States and the District <strong>of</strong> additional services if they choose, includingColumbia. The Federal Government provides mental health services such as inpatient psyfrom50 to 76 percent <strong>of</strong> the funding for chiatric services for children and the elderly;<strong>Medicaid</strong>, depending on State income levels, clinical services provided <strong>by</strong> a psychiatrist,and State and local governments provide the psychologist, or social worker; or outpatientrest. States retain primary authority over how rehabilitative services. 5the program is administered, but they must5However, States cannot receive Federalfollow certain Federal guidelines in order tomatching funds for services provided tocontinue receiving Federal funding. Theseadults aged 22 to 64 in institutions forguidelines specify which groups may andmental diseases.<strong>Administration</strong> <strong>of</strong> <strong>Mental</strong> <strong>Health</strong> <strong>Services</strong> <strong>by</strong> <strong>Medicaid</strong> <strong>Agencies</strong> 7

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