How Medicaid agencies administer mental health services: results from a 50-state survey

This brief report describes some notable variations in how state Medicaid agencies administer and fund Medicaid mental health services.

Hour-long telephone interviews were conducted with all state and District of Columbia Medicaid directors or their designees.

Responses indicated that Medicaid and mental health agencies were located within the same umbrella agency in 28 states, potentially facilitating collaboration. The mental health agency provided funding for some Medicaid mental health services in 32 states, and counties provided such funding in 22 states. Medicaid agencies generally delegated more authority to state mental health agencies in states where some Medicaid funding came from mental health sources and also in states where both agencies were in the same umbrella agency.

The increasing role of Medicaid in funding state mental health services, combined with new federal limits on Medicaid financing of these services, underscores the importance of interagency collaboration and better alignment of Medicaid and mental health responsibilities.