A unique approach to designing a comprehensive behavioral health system in New Mexico
A unique approach to designing a comprehensive behavioral health system in New Mexico
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DOI：
10.1176/appi.ps.55.9.983
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发表时间：
2004-09-01
影响因子：
3.8
通讯作者：
Hyde, PS
中科院分区：
文献类型：
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作者：
Hyde, PS
国家精神卫生政策选举官员，信仰社区，部落代表，消费者及其家人。这些系统将负责地方规划和查明服务差距，就地方一级提供服务的质量提供投入，并建立系统间转介和协作机制，以反映州在地方社区的协作努力。新墨西哥州在设计和实施部门间和医疗补助系统内行为健康系统重大变革方面的历史，尤其令人不安。医疗补助行为健康服务被雕刻成医疗管理护理组织全州的利益相关者的反对。为成年人建立了一个单独的非医疗补助服务区域结构。为儿童和青少年以及离开监狱的成年人提供的非医疗补助服务是直接签约的，无需使用中间人。具有讽刺意味的是，以前的决定，整合行为健康和医疗服务的医疗补助导致越来越多的问题之间的分裂行为健康服务资助的医疗补助和那些资助的其他来源和其他机构。每次设计和改变系统时，过渡都与提供者的混乱和启动成本以及消费者、消费者家庭和其他需要与行为健康提供者和服务接受者接口的系统的困难有关。新墨西哥州不想重复过去的错误。很难将行为健康服务从目前的医疗补助管理医疗组织中剥离出来，在这些组织中，药房、运输和护理协调服务和活动与医疗保健服务交织在一起。消除区域护理协调系统，发展地方护理系统，选择一个全州范围的实体来管理行为健康资金，然后过渡到这个实体将与中断有关。将由多个州政府部门签订的合同转移到一个全州范围的实体，
State Mental Health Policy elected officials, the faith community, tribal representatives, and consumers and their families. These systems will be responsible for local planning and identification of service gaps, providing input on the quality of service delivery at the local level, and creating intersystem referral and collaboration mechanisms to mirror the state collaborative effort in local communities.Since the mid-1990s, New Mexico’s history of designing and implementing major changes in the behavioral health system among departments and within the Medicaid system has been particularly troubling. Medicaid behavioral health services were carved into medical managed care organizations statewide over the objections of stakeholders. A separate regional structure for non-Medicaid services for adults was developed. Non-Medicaid services for children and adolescents and for adults leaving prisons were contracted directly without use of an intermediary. Ironically, previous decisions to integrate behavioral health and medical services within Medicaid led to increasing problems of fragmentation among behavioral health services funded by Medicaid and those funded by other sources and other agencies. Each time systems were designed and changed, transitions were associated with confusion and start-up costs for providers as well as difficulties for consumers, consumers’ families, and other systems that were required to interface with behavioral health providers and service recipients. New Mexico does not want to repeat mistakes of the past. It will be difficult to take behavioral health services out of the current Medicaid managed care organizations, in which pharmacy and transportation and care coordination services and activities are intertwined with health care services. Eliminating the regional care coordination system, developing local systems of care, selecting one statewide entity for the management of behavioral health dollars, and then making the transition to this entity will be associated with disruption. Moving contracts that have been entered into by multiple state departments to a single statewide entity will require careful