Patterson R F
Forensic Services, District of Columbia Commission on Mental Health Services, Washington 20032, USA.
J Am Acad Psychiatry Law. 1998;26(3):467-73.
This paper alerts practitioners and administrators in correctional healthcare settings to a variety of issues of concern when advising or negotiating with state or county governments on the provision of managed behavioral healthcare. The participation of the mental health practitioner or administrator involved in determining the quality and appropriateness of behavioral managed care contractual services is an essential component of an overall healthcare service in a correctional setting. Several crucial elements are outlined relative to correctional settings, including the interface between custody and treatment providers, crisis intervention for incoming detainees or inmates, and provision of services for longer term "no parole" inmates in correctional settings. A number of considerations are reviewed, including (1) staffing, (2) drug formularies, (3) levels of service, and (4) "hidden costs," that may influence contractual negotiations as well as service provision by managed behavioral healthcare companies in correctional settings.
本文提醒惩教医疗环境中的从业者和管理人员，在就提供管理式行为医疗保健与州或县政府进行咨询或谈判时，要关注各种相关问题。参与确定行为管理式护理合同服务质量和适宜性的心理健康从业者或管理人员，是惩教环境中整体医疗服务的重要组成部分。文中概述了与惩教环境相关的几个关键要素，包括监管人员与治疗提供者之间的衔接、对新收押的被拘留者或囚犯的危机干预，以及为惩教环境中“无假释可能”的长期囚犯提供服务。文中还审视了一些可能影响合同谈判以及管理式行为医疗保健公司在惩教环境中提供服务的因素，包括：（1）人员配备；（2）药品处方集；（3）服务水平；（4）“隐性成本”。
