Clients tossed out of behavioral health safety net invisible to number crunchers

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By Sherry Robinson

Rep. Phillip Archuleta was steamed.
“I’ve been told by hospital emergency room employees here and in Silver City that they’re flooded by clients who’ve been turned down by La Frontera,” he said.
State Human Services Department representatives tried to reassure the Las Cruces Democrat that new providers were told to hire all administrative and clinical staff, that there was no need to furlough counselors.
Archuleta wasn’t convinced: “What you’re telling me is not what I’m hearing out there.” He added, “My office is two blocks away from the provider. I see clients walking down the street talking to themselves, looking lost. There’s been nothing smooth about the transition.”
This exchange took place a month ago, during the legislative Behavioral Health Subcommittee hearing in Las Cruces on the subject of HSD’s closure of 15 behavioral health providers and their replacement with Arizona firms.
At that meeting, Diane McWilliams, director of HSD’s Behavioral Health Division, insisted that the transition had been smooth, that 88 percent of New Mexico staff members — everybody except billing personnel — were still in place, that there should be no interruption in service.
We have two realities — HSD’s and everybody else’s.
Last week, the advocacy group Disability Rights New Mexico sent HSD a five-page letter detailing disruption of service that continues three months after the “smooth transition.” Complaints include long waits for appointments, an inadequate number of providers and mentally delicate patients who aren’t receiving needed care.
Case in point: Southwest Counseling Services, the subject of Archuleta’s complaint, had 60 clients with severe psychiatric disturbances. After La Frontera took over, according to Disability Rights, the clinical director was fired, and the prescribing nurse left. “It is not clear to us who is managing this important, intensive clinical program, how it is providing the necessary wrap around services 24 hours a day and how medications are being prescribed and managed,” Disability Rights said.
La Frontera decided not to buy the vehicles Southwest Counseling had used to take clients, many of them poor and homeless, to the program for their services. Hence, the people Archuleta saw walking down the street muttering to themselves. La Frontera reportedly plans to use “tele-psychiatry.” Disability Rights questions how effective this will be “for people with the most serious mental illnesses.”
Further, Disability Rights “has heard disturbing reports from three unrelated sources that CYFD (the Children, Youth and Families Department) is not referring children in need of behavioral health services because those services are not available,” a violation of CYFD’s contract with feds.
Also last week, the Coalition of New Mexicans Fighting to Save Behavioral Health said the new providers rehired only about 60 percent of laid-off employees.
Earlier, the New Mexico Chapter of the American Academy of Child and Adolescent Psychiatry complained of a “needlessly disruptive” process. Two physicians wrote that teens with “severe, life-threatening emotional issues” were unable to get care and that treatment was interrupted or uncertain. “Clinicians themselves are unsure of a future in their current community or in New Mexico itself.”
HSD, amazingly, sticks to its smooth-transition story and dismisses complaints as “anecdotal,” claiming it needs data. Considering that HSD and its contractors possess data, why hasn’t somebody compiled and compared before-and-after lists of clients? That should be obvious, unless you don’t want to know the answer.
Disability Rights is collecting its own data. If you or anyone you know has had behavioral health services suspended or reduced, call them at 505-256-3100, or toll free 1-800-432-4682.
HSD now says it won’t seek an increase in state funding for Medicaid, citing low price inflation, more available federal money and lower use of services by recipients. So if services in a weakened safety net cost less, and recipients tossed out of the net can’t find their way back, that’s savings in a cold new world.