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Integrating Mental Health & Substance Abuse Strategies

Finance & Delivery of Services

Key Issues


Clarke Ross, D.P.A., Deputy Executive Director, National Alliance for the Mentally Ill, Arlington, VA.

In this session, Clark Ross, Deputy Executive Director of the National Alliance for the Mentally Ill, and former Executive Director for the American Managed Behavioral Healthcare Association, provided an overview of current key issues in the financing and delivery of mental health and substance abuse (MH/SA) services.

Among those issues presented were:

  • MH/SA expenditure patterns, including a breakdown of public and private sector sources of financing for these services.
  • An analysis indicating a reduction in the relative value of MH/SA benefits over time and an assessment of the potential causes for this decline.
  • An examination of the legislative initiatives requiring limits on MH/SA benefits to be no more restrictive than those imposed on other health care services ("parity" legislation), including an examination of drafting and implementation issues influencing the effectiveness of such requirements.
  • A discussion of significant number of persons with co-occurring mental health and substance abuse problems (an estimated 10 million persons in any 12-month period) and the important challenges associated with integrating MH/SA treatment efforts.
  • A discussion of the move to the provision of MH/SA services through managed care arrangements and the implications of this shift on individuals' access to care and the need for increased accountability and improved data to ensure that these new arrangements are meeting the needs of the individuals that they are contracted to serve.

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