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MANAGING MANAGED CARE: QUALITY IMPROVEMENT IN BEHAVIORAL HEALTH
Maternal and Child Health Block Grant (part of Title V of the Social Security Act), mental health programs, social services, foster care, substance abuse services, school-based clinics, special education, recreation programs, and the juvenile justice system. Given the multiplicity of funding streams and fragmentation of responsibilities among these agencies, the coordination of care across all systems is almost impossible (Burns et al., 1995; England and Cole, 1995; Newacheck et al., 1995). Studies have shown that only about one-third of children with severe problems get the needed services (Brandenburg et al., 1990; DOE, 1993; Knitzer, 1982; Stoul et al., 1994).
Managed behavioral health care plans serving children and their families face the added challenge of providing family-centered services that need to interface with the multitude of systems that serve children.
National Mental Health Association
Public Workshop, April 18, 1996, Washington, DC
National policy for children's mental health services promotes “systems of care,” based on principles and values of the Child and Adolescent Service System Program (CASSP). Initiated in 1984 through the National Institute of Mental Health, CASSP was the first federally funded initiative responding to the needs of children and adolescents with serious emotional disturbances. Although in 1993 it was renamed the Planning Systems Development Program, the CASSP principles have wide support among state agencies, professional organizations, and advocacy groups concerned with children and adolescents. These principles include (SMHRCY, 1995):
coordination of care;
individualized treatment on the basis of need;
culturally competent services;
active involvement of families and surrogate families (e.g., foster care) in the development of treatment plans;
commitment to providing the least restrictive, most normative environment that is clinically appropriate.