Utah’s Behavioral Health System

Non-profits Special Services Distr.

13 Local AuthoritiesCounty Gov.

DSAMH

County Department

For-profitMCO

Indep. Providerorganizations

Medicaid Eligible Clients in 2014

FY 1994

FY 1995

FY 1996

FY 1997

FY 1998

FY 1999

FY 2000

FY 2001

FY 2002

FY 2003

FY 2004

FY2005

FY2006

FY2007

FY2008

FY2009

FY2010

FY2011

FY 2012

FY 2013

FY 2014

0

10000

20000

30000

40000

50000

60000

70000

18820 18197 17431 1751920813

27501 29079 27197

37119

45000

60000

Clients Served in Utah CountyCurrently: Medicaid Eligible Clients = 7000

Uninsured/ Underinsured Clients = 500

By 2014: Medicaid Eligible Clients = 10,500 – 14,000

Uninsured/ Underinsured Clients = 500 - 700

Challenges:Þ Service mix of the “new eligibles” will be different than current CMHC service mix

Þ Current funding streams don’t allow for expansion of infrastructure

Þ Increased focus on integrated healthcare challenges traditional role of CMCHC

Dynamic Tension or Tense Dynamic ?

Growth

Increase in Eligibles leads to:

– Service expansion– Investment in infrastructure– Integration with Physical Health– Workforce build up– Cost effectiveness/ comparisons

Cost Containment

Increased Oversight leads to:

– Increased documentation– OIG/ Medicaid Integrity– Increased administrative burden– Fraud/ Waste/ Abuse reduction– Budget cuts lead to service restriction

This is the place (for CMHCs)

Community (Mental) Health Center

Physical Health Services

Behavioral Health Services

Wellness Services