Public-Sector Managed Care for Children's Mental Health Services : Stakeholders' Perspectives. Symposium / Dalene K. Stangl, Dan L. Tweed and Betsy Farmer.

This paper presents contributions at a symposium about Carolina Alternatives (CA), a North Carolina program that blends capitated financing with public sector managed care for mental health and substance abuse services for children and youth eligible for Medicaid. The symposium focused on stakeholders' perspectives and on expenditure patterns of inpatient and outpatient services. First, Dan Tweed presented "Stakeholders' Perspectives: Overview of Carolina Alternatives." Next, Dalene Stangl presented "Stakeholders' Perspectives: Area Programs, Hospitals, and Departments of Social Services." The perspectives of three groups (the 10 area programs responsible for care management, the hospitals that provide mental health and substance abuse services, and the county directors of departments of social services) regarding how CA restructured service delivery, implemented care management, and redefined interagency relations are defined. Elizabeth Farmer and Julia Gagliardi presented "Stakeholder's Perspectives: Client Satisfaction and Outcomes." Preliminary results indicated overall client satisfaction and acceptability of the outcome measures to clients and staff. The final contribution, by David Langmeyer, "Stakeholders' Perspectives: Preliminary Cost Findings," compared service costs between area programs that participated in CA and those that did not. It found CA was successful in reducing costs associated with inpatient services but this decrease was offset by a dramatic increase in non-inpatient services for participating area programs. (DB)

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