Foreword

During this time of financial uncertainty and change in the Nation's health care systems, the Center for Substance Abuse Treatment (CSAT) is proud to provide the substance abuse and mental health fields with this Technical Assistance Publication (TAP), Contracting for Managed Substance Abuse and Mental Health Services: A Guide for Public Purchasers. The document is a comprehensive guide for public purchasers and others interested in influencing the development of requests for proposals (RFPs) and contracts in managed behavioral health care. Experts in both the substance abuse and mental health fields collaborated in its development.

It is generally agreed that strong contracts between purchasers of health care services and managed care organizations (MCOs) form the foundation upon which managed behavioral health systems are built. Unfortunately, some public purchasers have left themselves and their clients vulnerable to poor quality services and restricted access due to poorly conceptualized and poorly written RFPs and contracts. This guide provides information that will help public purchasers develop RFPs and contracts for managed behavioral health care so as to achieve programmatic success. Although this guide is intended to assist public purchasers in their managed care contracting efforts it should not be used as a substitute for expert legal or financial guidance. Any recommendations put forth here should be carefully considered by purchasers and adapted with appropriate guidance to meet the needs of the specific State or locality.

This TAP is targeted most specifically to State and county substance abuse and mental health authorities, State Medicaid authorities, and other payers and purchasers of managed mental health and/or substance abuse services. CSAT hopes, however, that substance abuse and mental health treatment providers, MCOs, consumer groups, advocacy groups, academicians, and researchers will find the document an informative discussion of the essential elements of managed care contracting for substance abuse and mental health services.

This document was developed by CSAT using national experts as an advisory panel. Once published, TAPs generally are not revised, and the development process ends. Traditional ways of developing and disseminating knowledge are changing, though, and CSAT recognizes that a document on a topic as dynamic as managed care contracting must be very accessible and continually updated if it is to continue to be useful. Therefore, CSAT has made this TAP available on the Internet and plans to update the information contained within it on a regular basis. Internet accessibility will provide readers of this TAP with a mechanism for asking questions, contributing new material, and providing ongoing feedback on the guide. We hope that this document will serve as a model for developing and disseminating essential information in an online, interactive, and continually updated manner.

CSAT invites you to use this guide to better understand how to develop RFPs and contracts for managed behavioral health care systems that live up to their promise of providing state-of-the-art services to people with mental health and addictive disorders. We further invite you to use your knowledge and experience to contribute to its continual evolution so that it may better serve others.

Nelba Chavez, Ph.D.
Administrator
Substance Abuse and Mental Health Services Administration

Camille T. Barry, Ph.D., R.N.
Acting Director
Center for Substance Abuse Treatment

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