Medicaid Managed Care - U.S. Senate Special Committee on Aging

affect many different facets of an individual's
life. Moreover, experiences with
managed health and mental health care
raise important cautions concerning the
interplay between economic incentives and
maintaining the integrity of service delivery.
In public developmental disabilities systems,
the Introduction of managed care
must be approached cautiously and with
full recognition that new and distinctive
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managerial strategies will be required to
successfully adapt managed care technology
to the needs of people with life-long
disabilities and their families. It Is enormously
Important that system stakeholders
play a central role during all
stages of defining how such techniques
are to be applied if the end result is to be
a service system that advances shared
beliefs and leads to valued outcomes.
INSTITUTING A MANAGED CARE SYSTEM
Any attempt to accomplish systemic
change through a managed care
approach must be framed by public
policies that clearly articulate the central
goals of the public system while ensuring
<strong>Managed</strong> <strong>Care</strong> Framework
that the interests of people with developmental
disabilities and the public at large
are protected. A suggested policy framework
for the introduction of managed care
to MR/DD service systems is outlined
below.
* The central mission of the public system should be to enable individuals with developmental dis-
. abilities to live everyday lives, achieve self-sufficiency, exercise self-determination, and become
integral; valued members of their communities;
* Individuals, families, and service providers should maximize the use of natural supports and
other community assets in meeting the needs of each person;
* Individuals and families should have access to necessary and effective services and supports
consistent with the limitations imposed by available resources;
t The responsibilities of the public system in responding to individuals in crisis should be clearly
delineated;
* Family supports should be emphasized both as a means of making more effective use of scarce
resources and as a firm foundation for building circles of community support for individuals
with disabilities;
* Individuals and families should be given the-option of directing the delivery of services and
supports within reasonable policy parameters;
* The service system should be managed on the basis of performance and outcomes;
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