Managed Behavioral Healthcare in Correctional Settings

This paper alerts practitioners and administrators in correctional healthcare set-tings to a variety of issues of concern when advising or negotiating with state or county governments on the provision of managed behavioral healthcare. The participation of the mental health practitioner or administrator involved in deter-mining the quality and appropriateness of behavioral managed care contractual services is an essential component of an overall healthcare service in a correc-tional setting. Several crucial elements are outlined relative to correctional set-tings, including the interface between custody and treatment providers, crisis intervention for incoming detainees or inmates, and provision of services for longer term "no parole " inmates in correctional settings. A number of consider-ations are reviewed, including (1) staffing, (2) drug formularies, (3) levels of service, and (4) "hidden costs, " that may influence contractual negotiations as well as service provision by managed behavioral healthcare companies in correc-tional settings. The concerns about managed care in the general community have generated more inches of print in most newsletters and journal publications than perhaps any other topic in recent years. While the general public and the courts are begin-ning to realize the pros and cons of man-aged care, there is another population that has been more affected by managed care on an individual and systems basis than perhaps any other. This population con