Brothers, Mary Kay--FL

1.) All Medicaid managed behavioral health care contracts should be managed at the local area office level for the counties covered by the Area Office. Having contract managers at the state level results in missed opportunities to modify or impact the care being provided at the local level. Local contract managers understand their individual area's system of care as well as the individual proviiders. Local managers have relationships with behavioral health staff monitoring Medicaid providers for quality and perfornance. Behavioral health care is much more difficult to analyze for quality and efficacy, the nuances are very different than those for physical health care. 2.) 1 in 166 children will be diagnosed with Autism Spectrum Disorder. We are missing the mark for treating these children completely with standard behavioral health interventions. These children frequently end up in high end resiidential placements for months or years with no notable progress because these programs are not designed to meet their complex needs. Commercial insurances in Florida are now statutorily required to provide some coverage for it's treatment. Medicaid needs to address this population and encourage innovations in community based treatment. These children do worse when separated from family and home, sending them to residential placements, often 2 hours or more from their communities, exacerbates the problem.