Increasingly, states are turning to managed care to deliver health services to Medicaid recipients. In a 1994 survey of states conducted by the National Academy for State Health Policy, 16 states reported that they enroll elders in Medicaid managed care programs. A few states (Arizona, Minnesota, Oregon, Tennessee, Utah) require mandatory enrollment and others allow elders to voluntarily select a managed care plan. Still other states plan to include mandatory enrollment of SSI recipients in a subsequent phase of their programs (eg., Hawaii, Ohio, Oklahoma). In addition, states are in various stages of including long term services as part of a benefit package available through managed care. A number of states have developed explicit managed care initiatives – Arizona, Florida, Minnesota, Wisconsin. Other states are planning similar initiatives for elders (eg., Colorado, Connecticut, Oklahoma, Maine, Maryland, Massachusetts, Texas).