This article examines the principal structures and mechanisms used by federal and state government to fund the behavioral health needs of Native American Indians. Using Arizona as a case study, the article provides an overview of both federal and state programs, especially Medicaid, discussing the problems and strengths of each. The article concludes with a discussion of the policy implications of these programs for both states and tribes, focusing on issues concerning administrative complexity, tribal sovereignty, improving behavioral health services, and assignment of financial risk.
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