Contributing to System Change in Kentucky

SUMMARY

Currently a change that requires monitoring and action is the state public payers' movement toward managed behavioral health care and the re-structuring of Medicaid to reflect this movement. In this article the response of one state, Kentucky, to managing Medicaid costs, quality and access is reported. The author's participation in a multi-disciplinary effort to identify outcomes and outcome measures for the state's managed behavioral healthcare system is described. The proposed Medicaid waiver for mental health and substance abuse and the resulting implications for occupational therapy are discussed.