Did Project Liberty displace community-based medicaid services in New York?
OBJECTIVE
This study analyzed how the introduction of Project Liberty services after the September 11, 2001, terrorist attacks affected agencies' provision of community-based Medicaid mental health services in the New York metropolitan area.


METHODS
Provision of Medicaid mental health services was tracked between January 2000 and June 2003 for provider agencies participating in Project Liberty (N=164) and for a comparison group of mental health provider agencies that did not participate in this program (N=94).


RESULTS
Overall, participation in Project Liberty did not significantly affect the volume of Medicaid services provided. However, for agencies with one site, a statistically significant difference was seen; compared with agencies in the comparison group, agencies that participated in Project Liberty claimed a mean+/-SE decrease of $4.66+/-3.57 less in Medicaid services per month per Project Liberty visit.


CONCLUSIONS
Project Liberty permitted rapid expansion of the total volume of services provided by community-based organizations without interfering with the provision of traditional services, although a modest effect was seen for smaller agencies. Although the results do not imply that "supply side" planning for disaster needs would not improve system response, they do imply that implementation of flexible "demand side" financing can call forth a large volume of new services rapidly and without interfering with other community services.
Gomes
Carla
C
Department of Psychiatry, Division of Health Services Research, Mount Sinai School of Medicine, New York City, USA.
McGuire
Thomas G
TG
Foster
M Jameson
MJ
Donahue
Sheila A
SA
Felton
Chip J
CJ
Essock
Susan M
SM
D003156:Community Mental Health Services / Q000191:economics* / Q000706:statistics & numerical data*; D003361:Cost Allocation / Q000191:economics / Q000706:statistics & numerical data; D003362:Cost-Benefit Analysis / Q000191:economics / Q000706:statistics & numerical data; D003419:Crisis Intervention / Q000191:economics* / Q000706:statistics & numerical data*; D003695:Delivery of Health Care / Q000191:economics* / Q000706:statistics & numerical data*; D004189:Disaster Planning / Q000191:economics / Q000706:statistics & numerical data; D005380:Financing, Government; D005500:Follow-Up Studies; D005610:Freedom; D006301:Health Services Needs and Demand / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008484:Medicaid / Q000191:economics* / Q000706:statistics & numerical data*; D009519:New York City; D012016:Reference Values; D047851:September 11 Terrorist Attacks / Q000191:economics* / Q000706:statistics & numerical data*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology* / Q000628:therapy; D014600:Utilization Review / Q000706:statistics & numerical data