title: Impact of Medicaid managed mental health care on delivery of services in a rural state: an AMI perspective.
abstract: In March 1995 Iowa implemented a statewide mental health carve-out program under a Medicaid Section 1915b waiver. A goal was to provide equal access across counties for Medicaid recipients by introducing a statewide network of service providers. Problems have included the contractor's authorizing only services considered medically necessary for persons with serious mental illness, who also need community supports; contractor staff's lack of knowledge about regional resources and the limited availability of community-based services in most rural areas; clients' difficulty in gaining access to the new system; denial of inpatient hospitalization; untimely provider payments; and lack of education for providers, consumers, and families.
authors.affiliation: Alliance for the Mentally Ill of Iowa, Des Moines 50322-1903, USA.
authors.forename: M
authors.initials: M
authors.lastname: Stout
mesh_terms: D003284:Contract Services; D006801:Humans; D007484:Iowa; D008329:Managed Care Programs / Q000458:organization & administration / Q000592:standards*; D008484:Medicaid / Q000458:organization & administration* / Q000592:standards; D008605:Mental Health Services / Q000592:standards*; D010344:Patient Advocacy; D015397:Program Evaluation; D011787:Quality of Health Care; D019035:Rural Health Services / Q000592:standards*; D013221:State Health Plans / Q000458:organization & administration* / Q000592:standards; D014481:United States