**GAO-04-387**                      Published: Mar 31, 2004. Publicly Released: Apr 30, 2004.                  

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## Highlights

Since 1975, the District of Columbia has operated its mental health system under a series of court orders aimed at developing a community-based system of care for District residents with mental illnesses. Placed in receivership from 1997 to 2002, the District regained full control of its mental health system in 2002 but has been ordered to implement a courtapproved plan for developing and implementing a community-based mental health system. Additionally, the District must comply with exit criteria, which must be met in order to end the lawsuit. The court expects that it will take the District 3 to 5 years to implement the courtordered plan and begin measuring performance against the exit criteria, with year 1 beginning in July 2001. GAO was asked to report on the current status of the District's efforts to develop and implement (1) a mental health department with the authority to oversee and deliver services, (2) a comprehensive enrollment and billing system that accesses available funds for federal programs such as Medicaid, (3) a consumer-centered approach to services, and (4) methods to measure the District's performance as required by the court's exit criteria.

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## Topics

Government Operations

Assertive community treatmentBilling proceduresClaims processingCommunity-based mental health servicesCommunity health servicesConsumer protectionData collectionFederal courtsMedicaidMedical expense claimsMental care facilitiesMental health care servicesPerformance measures