ABSTRACT
Introduction .................................................................................................................................... 122 Description of a Community Mental Health Center ...................................................................... 122
Staffing ...................................................................................................................................... 122 Types of Covered Services ....................................................................................................... 123 Sources of Clients ..................................................................................................................... 125 Regulatory Environment ........................................................................................................... 126 Types of Revenue ...................................................................................................................... 126 Other Resources ........................................................................................................................ 128
Issues Affecting Community Mental Health Programs ................................................................. 128 Fragmented Entry Process into the Mental Health System ....................................................... 128 Shortage of Qualified Mental Health Providers ........................................................................ 128 Administrative Challenges ........................................................................................................ 129 Medical and Mental Health Parity ............................................................................................ 130 Coding Classification ................................................................................................................ 131 Medication and Pharmaceutical Direction ................................................................................ 132 Decentralization ........................................................................................................................ 133 Increased and Diversified Patient Populations .......................................................................... 133
Facility Payments ........................................................................................................................... 133 Future Options for Community Mental Health Centers ................................................................ 134
Internal Reorganization ............................................................................................................. 134 Patient Protection and Affordable Care Act (PPACA) .............................................................. 135 Combined Mental and Medical Health Centers ........................................................................ 135 Privatization .............................................................................................................................. 136
An Examination of the Privatization Option .................................................................................. 137 Another Potential Option: Federal Qualified Behavioral Health Centers (FQBHC) ................ 141
Conclusion ..................................................................................................................................... 141 Acknowledgments .......................................................................................................................... 141 Appendix 1 ..................................................................................................................................... 142
Bidder Evaluation ...................................................................................................................... 142 Appendix 2 ..................................................................................................................................... 142
Request for Proposal ................................................................................................................. 142 Mental Health Support Groups ...................................................................................................... 151 Mental Health Professional Publications ....................................................................................... 151 Mental Health Professional Organizations .................................................................................... 152 References ...................................................................................................................................... 154
Community Mental Health Centers, also referred to as County Mental Health Centers, treat patients usually with no or limited insurance in a domiciliary setting versus an inpatient state or community facility. Both children and adults are eligible to receive such assistance. These programs provide a wide range of psychiatric and counseling services to the residents in their community as well as other types of assistance, such as:
• Treatment services related to substance abuse • Housing, including halfway hours • Full or partial supervision day centers • Employment services • Information and education services • Referrals • Consultative services to schools, courts, and other agencies • Self-help groups • After-care services • Other related activities
The community facilities generally include outpatient clinics, community/county mental health programs, short-term psychiatric facilities, day-care centers, de-toxification centers, residential rehabilitation centers for substance abuse, vocational training, residential care, long-term care psychiatric facilities, and Veterans Affairs (VA) psychiatric centers. The community centers may be co-located with other county services such as social services, occupational rehabilitation services, information technology services, human resources, maintenance services, and others or may be independently located.
