The number of state governments with managed behavioral health care programs has tripled in three years, from 14 state-implemented managed care programs in 1996 to 42 states with such programs in 1999, according to the latest analysis of the Substance Abuse and Mental Health Services Administration's (SAMHSA) Managed Care Tracking System.

 Developed by SAMHSA's Office of Managed Care, this annual report, State Profiles, 1999, On Public Sector Managed Behavioral Health Care, shows that states increasingly are using managed care to meet their needs for treatment of substance abuse and mental health disorders. The report cites Medicaid as the largest source of funding for these public (government agency) behavioral health care programs.

  "This report is an encyclopedia of valuable information on the continuing efforts of individual States toward providing access to quality care to those in need of treatment for substance abuse and mental health disorders," said SAMHSA Administrator Nelba Chavez, Ph.D. "Findings of the report broaden our collective knowledge base and will further enable us all–SAMHSA and its State partners–to seek out and put into place those treatment systems that work best."

  Office of Managed Care Associate Administrator Eric Goplerud, Ph.D., said, "As SAMHSA and the states seek to encourage more alternatives to institutional care, this snapshot of all public managed behavioral health care programs indicates that those programs, operating on their own and separate from managed physical health care, are more likely to provide support services of rehabilitation and consumer-run services."

  Major findings of the report include:

• There is wide diversity in the types of organization, financing and structure among the States' managed behavioral health care programs, with some covering multiple populations or areas , some limited to certain populations or to one county or region, and some are risk-based, while others remain fee-for-service through administrative service-only contracts.
• While Medicaid agencies most often serve as the primary purchaser for managed behavioral health care programs, State mental health and substance abuse authorities work in collaboration with Medicaid agencies, particularly for carve-out (stand-alone) mental health and substance abuse treatment programs.
• Carve-outs, those managed behavioral health care programs separate from managed physical health care, are more likely to provide such community-based services as residential, rehabilitation, support, and consumer-run services, while integrated managed health care programs, covering both behavioral and physical health care, are more likely to provide pharmacy services.

The SAMHSA report examines how State mental health and substance abuse managed care programs are organized, administered, financed and delivered. States are evenly split between integrated programs, where both physical and behavioral health services are under one program, and carve-out programs which provides mental health and substance abuse services in a separate program. The SAMHSA report identifies many important differences in these programs.

 The data analysis scrutinizes all public behavioral health care programs in a national summary of findings, State-specific information and program descriptions. The tracking project will publish a supplement updating the profiles in 2000. To receive a copy of the State profile report, please contact the National Clearinghouse on Alcohol and Drug Information (NCADI) at 800-729-6686.

The Office of Managed Care is a component of SAMHSA, an agency of the U.S. Department of Health and Human Services. SAMHSA is the lead Federal agency for improving the quality and availability of substance abuse prevention, addiction treatment, and mental health services in the United States. News media requests for information on SAMHSA's substance abuse and mental health programs should be directed to Media Services at 1-800-487-4890. The report and this release may be obtained on the Internet at www.samhsa.gov