Providing Mental Health Services to TANF Recipients: Program Design Choices and Implementation Challenges in Four States. Contracted Service Providers


In some local offices, mental health services are provided in the contracting agency's office by a mental health counselor. The screening and assessment services provided by the mental health counselor are paid for with TANF funds, but the treatment may be paid for either by TANF or Medicaid funds. In this arrangement, the employment case manager refers clients with mental health conditions to the contracted mental health service provider. Outreach workers in Florida and some mental health counselors in Oregon provide services out of the agency where they are employed.

One advantage of providing mental health services out of the contracted service provider's offices is that clients "look like" other nonwelfare individuals receiving mental health services, removing the stigma of being identified as welfare recipients and thereby making it more likely that they will stay in treatment. The drawback is that, unless clients are directly and quickly linked to mental health staff, they may not participate in mental health services, or they may miss appointments because of the inconvenience of traveling to a location apart from the welfare office, especially if they are ambivalent about participating in mental health services to begin with.

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