Managed behavioral healthcare in correctional settings

This paper alerts practitioners and administrators in correctional healthcare settings to a variety of issues of concern when advising or negotiating with state or county governments on the provision of managed behavioral healthcare. The participation of the mental health practitioner or administrator involved in determining the quality and appropriateness of behavioral managed care contractual services is an essential component of an overall healthcare service in a correctional setting. Several crucial elements are outlined relative to correctional settings, including the interface between custody and treatment providers, crisis intervention for incoming detainees or inmates, and provision of services for longer term "no parole" inmates in correctional settings. A number of considerations are reviewed, including (1) staffing, (2) drug formularies, (3) levels of service, and (4) "hidden costs," that may influence contractual negotiations as well as service provision by managed behavioral healthcare companies in correctional settings.