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Notes from the field: CMS Call discussing NM Behavioral Health

Some highlights from the Aug. 28, 2013 CMS listening call to hear from behavioral health consumers on the disruption of service due to HSD process of Medicaid funding freeze and bringing in AZ takeover companies.

  • 27 callers were heard.
  • Callers were told not to discuss the “fraud” issue.
  • Many consumers noted that the timing and method of the call was not accessible to most consumers of behavioral health services (working parents, non-English speakers, children, homeless persons, persons in jail or in the juvenile justice system.  Others complained about the lack of outreach to let people know about the call other than email or facebook postings.
  • Callers noted that a quarter of the time for consumers to give their input was taken by HSD defending their actions or countering with their actions to resolve issues.
  • Stories from across the state painted some of the vivid picture of the disruption of services that has taken place, including not being able to get appointments and medications. Many parents reporting disruptions of service for their children.  Lack of contracts by new AZ provider agencies with psychologists who can prescribe medications.
  • Many consumers noted that consumers and their communities were “scared”, “frightened and threatened" by the type of actions taken by HSD. Some described the HSD action as a dangerous future precedent.
  • Consumers complained they received no notification or explanation of changes either from HSD or the new providers. Had to learn about it word of mouth or in the media.
  • One therapist whose takeover situation is down from 12 to 3 therapists for several thousand clients says they now have to do new intake forms which take up to 2 hours.  This results in long waits until this process is completed.
  • Various callers discussed behavioral health professionals either leaving rural areas or the state because of the HSD takeover process.  Two referred to the “ripple effect” across NM and its communities.
  • Callers from Native American communities noted that their communities would be hardest hit both by the disruption of service and the decrease in providers in NM.
  • Various callers called for HSD to “change direction,” restore previous provider agencies, etc.
  • Several callers outlined impact on frontier communities where services are already precarious.
  • Several callers discussed the lack of contracts with BMS workers so children who needed these services couldn’t be in school.
  • An attorney noted that assessments for infants in state care were not happening in her affected area so parents couldn’t start the process to get their children back - with a disastrous effect on family.
  • Callers talked about disruption leading to potential hospitalization and reliance on ER services that didn’t resolve issue. One caller talked of dual diagnosis person who is in a nursing home because of lack of services – this is not an appropriate place for care.
  • A psychologist from one of the pueblos discussed cultural competency and that NM was very different from AZ in cultures and poverty despite the AZ takeover entities’ claims to the contrary. Gave clear examples from tribal and Hispanic traditional societies where it takes extended time of years in these communities to gain real insight into the cultural issues.  Said that bringing in AZ agencies was in fact saying culture doesn’t matter. 
  • One caller called on HSD to put boots on the ground in the affected communities and hold community forums.  When HSD said they would do so with 6 months, the caller deemed that was not acceptable.
  • One caller: “Government has failed consumers and I don’t know how you can sleep at night.”

  

If people have crisis situations, they should call:  855-662-7474

If people have care coordination issues, they should call 866-660-7185

 

Also, active Facebook groups for this issue can be found here:

1) New Mexico Rising Up - https://www.facebook.com/nmrising 

2) Save Behavioral Health https://www.facebook.com/SaveBehavioralHealthNM

 

- Notes by Barbara

Health Action