How To Pay for Paraprofessionals in Mental Health and Substance Abuse Services]

Comments are provided on how paraprofessionals are financed in the fields of mental health and substance abuse services. With the exception of registered nurses, the term, paraprofessional, includes anyone with less than a masters degree who delivers direct care, educational, or treatment services related to mental health and substance abuse. Statistics indicate that the majority of paraprofessionals are employed in inpatient programs and paid for on salary. However, there are increasing numbers of paraprofessionals employed in a wide variety of community services with varying degrees of supervision. Most of these are also paid for on salary. Moreover, paraprofessionals appear to be more easily employed in organizations which are funded under grants, contracts, appropriations, or on a capitation basis rather than under a fee-for-services rendered basis. However, restrictions on the qualifications of those who may be reimbursed through third-party payments, State licensing practices, and standards for institutional accreditation, limit the flexibility of agencies to employ a range of paraprofessionals in their programs. Consequently, two major models of payment appear to be on the horizon. One method is that in which each unit of service and its appropriate provider is defined, costed out, and paid to render a range of services. In the second method, organizations are accorded provider status and paid to render a range of services. However, the individuals employed in such organizations may be required to be have credentials.