Bertsch E F
New York State Office of Mental Health, Niskayuna.
Hosp Community Psychiatry. 1992 Nov;43(11):1109-13. doi: 10.1176/ps.43.11.1109.
Fragmentation in the delivery of community support services is often identified as a major barrier to persons with severe mental illness, preventing them from living productive lives in the community. In Nassau County, New York, in 1989 a voucher process was created to allow service users to develop individualized support networks by purchasing services directly and by pooling funds to start new services. The voucher process is part of an intensive case management program. Goals set in the individual service plans of users guide voucher purchases. The local Mental Health Association manages funds based on a bank credit card model. The user, the case manager, and a staff member from an agency designated by the user review expenditures quarterly. The first year of operation is described, and suggestions for developing a voucher process, such as the need for extensive retraining of users and providers, are offered.
社区支持服务提供过程中的碎片化现象常被视为严重精神疾病患者面临的主要障碍，这阻碍了他们在社区过上有意义的生活。1989年，纽约拿骚县设立了一种代金券程序，允许服务使用者通过直接购买服务以及集中资金开办新服务来建立个性化的支持网络。该代金券程序是强化个案管理项目的一部分。使用者个人服务计划中设定的目标指导着代金券的购买。当地心理健康协会基于银行信用卡模式管理资金。使用者、个案管理员以及使用者指定机构的一名工作人员每季度审查支出情况。文中描述了该项目运营的第一年，并就开发代金券程序提出了一些建议，比如需要对使用者和服务提供者进行广泛的再培训。
