NAMI Criticizes Arkansas Officials For Lack Of Consumer Input On Managed Care Plan

Posted on August 13, 1999

Arlington, VA - The nation's largest advocacy organization for persons with mental illness today criticized Arkansas state government for inadequate consumer education and input in proposing significant changes to the state's adult mental health service system, following a hearing Tuesday in Little Rock on a Medicaid managed care plan.

"Nationwide, experience tells us that successful delivery programs under Medicaid managed care require constant consumer education and input," said Laurie Flynn, executive director of the National Alliance for the Mentally Ill (NAMI). "Arkansas has held only one public hearing on its new Gatekeeper plan, only at the state level, and only after the plan already was put out to bid. Medicaid and Division of Mental Health officials are railroading a process that has not provided adequate protection of consumer interests. It also represents a game of 'bait and switch,' in which the rules were changed after consumers first were asked to focus on a different proposal, limited to children and adolescents."

"From a national perspective, the process is shameful." Flynn said. "It is especially troubling in light of the fact that NAMI only recently honored the Arkansas Department of Human Services and Division of Mental Health for outstanding public education on mental illnesses. It does not reflect the kind of standards the people of Arkansas should expect and demand."

"We are stunned," said NAMI Arkansas executive director Kathy Schmidt. "Initially, the Medicaid Gatekeeper program covered only children and adolescents. Consumer advocates were involved from the beginning in service delivery design and families statewide were educated about proposed changes covering kids. But then the state announced that the plan would include adults, and new changes were proposed. There has not been a timely open door for consumer education, evaluation, and feedback."

NAMI supports several procedural components for any Medicaid behavioral health managed care programs:

• Consumers and families must be included in service delivery design, the bidding process, and implementation.
• State and local public hearings, education and outreach for consumers and families must be conducted.
• Consumer advocates must be employed as community liaisons or ombudspersons.
• Independent third party consumer and family monitoring teams must be established early during implementation.