The National Plan for the Chronically Mentally Ill: a review of financing proposals

In this, a companion piece to the preceding article, the author summarizes and examines the financing issues and recommendations set forth in the National Plan for the Chronically Mentally Ill. The major federal programs that provide assistance to chronic patients are described briefly. Sixteen proposed incremental reforms designed to fill gaps in the existing service system are listed and discussed; nine involve changes in the Medicaid program. The author also considers the options to go beyond incremental changes toward the establishment of a comprehensive program focused specifically on the needs of the chronically mentally ill. He discusses the advantages and drawbacks of three methods of organizing financing of mental health services that are described in the National Plan--a structured services program, a benefit-voucher program, and a cash transfer program.