1. Utah’s Behavioral Health System Non-profits Special Services Distr. 13 Local Authorities County Gov. DSAMH County Department For-profit MCO Indep. Provider organizations

2. Medicaid Eligible Clients in 2014

3. Clients Served in Utah County Currently: Medicaid Eligible Clients= 7000 Uninsured/ Underinsured Clients= 500 By 2014: Medicaid Eligible Clients= 10,500 – 14,000 Uninsured/ Underinsured Clients= 500 - 700 Challenges:  Service mix of the “new eligibles” will be different than current CMHC service mix  Current funding streams don’t allow for expansion of infrastructure  Increased focus on integrated healthcare challenges traditional role of CMCHC

4. Dynamic Tension or Tense Dynamic ? Growth Increase in Eligibles leads to: –Service expansion –Investment in infrastructure –Integration with Physical Health –Workforce build up –Cost effectiveness/ comparisons Cost Containment Increased Oversight leads to: –Increased documentation –OIG/ Medicaid Integrity –Increased administrative burden –Fraud/ Waste/ Abuse reduction –Budget cuts lead to service restriction

5. This is the place (for CMHCs) Community (Mental) Health Center Physical Health Services Behavioral Health Services Wellness Services