New York State Hearing on Governor Paterson’s Proposed Budget Cuts
Brookhaven Town Hall Auditorium
Farmingville, New York
Testimony by Andrew Malekoff, Executive Director / CEO
North Shore Child and Family Guidance Center
480 Old Westbury Road
Roslyn Heights, New York 11577
Representing the Long Island Coalition of Behavioral Health Providers, Inc.
400 Garden City Plaza – Suite 202
Garden City, NY 11530
October 27, 2009
Good afternoon senators. My name is Andrew Malekoff and I am the executive director and CEO for North Shore Child and Family Guidance Center in Roslyn Heights, New York. I am here representing the Long Island Coalition of Behavioral Health Providers.
More low income and middle-class families than ever before are in need of low cost, high quality community-based mental health care. Yet, the New York State Office of Mental Health is implementing a plan for these critical services that will result in a system of community care where only those children and families with Medicaid “fee for service” insurance coverage will be assured ongoing access to care. At the same time, Governor Paterson has proposed cutting local assistance dollars for behavioral health services.
The erosion of local assistance funding in conjunction with the march towards clinic reform is the perfect storm for the destruction of children’s community-based mental health services on Long Island. There will be no real cost savings left in the wake of this storm; only the incalculable cost of young lives being lost and set adrift, and families being splintered and destroyed.
For more than half a century North Shore Child and Family Guidance Center has been a proud provider of community-based mental health services on Long Island. The lethal mix of clinic reform and decades of diminished local assistance dollars portends a mental health delivery system that will no longer assure access to mental health care for children regardless of their parents’ ability to pay.
A once proud community-based mental health care system that was “for one and for all” is being systematically deconstructed into a depleted “Medicaid-only, others need not apply” delivery system.
New York State has a statutory responsibility to make sure that its most vulnerable citizens, our children, get care regardless of their families’ economic status. Instead, what we are getting is institutionalized classism that cuts the middle class and working poor out of the behavioral health equation.
Many children with what seems like ample health insurance coverage will no longer receive behavioral healthcare services from community clinics as a result of the lack of parity between government (Medicaid) rates and rates paid by commercial insurers for behavioral health care. And, despite rhetoric to the contrary, the new Federal Mental Health Parity Act will not help. Offering unlimited clinic visits at substandard rates is not parity, but rather a barrier that denies access to the middle class and working poor. Commercial insurers that cannot demonstrate an adequacy of network for behavioral health care should have their licenses revoked by the State Department of Insurance.
Community clinics have always been a mainstay in addressing the needs of children and adolescents with serious emotional disturbances and their families. Private psychotherapists and counselors, with rare exception, cannot and afford to offer the labor intensive work necessary to properly serve families that are struggling with serious emotional disturbances.
We call on New York State, in conjunction with local government, to restore and enhance rather than slash local assistance funding – a partnership between local and state government, the local community and client-consumer. Action must to be taken now to reverse the course of clinic reform and to preserve local assistance funding before it is too late.
Thank you, senators, for holding this hearing and for giving me the opportunity to testify before the committee.
Andrew Malekoff is executive director and chief executive officer for North Shore Child and Family Guidance Center, Roslyn Heights, New York email: amalekoff@northshorechildguidance.org
Saturday, October 31, 2009
DENTALLY CHALLENGED
DENTALLY CHALLENGED
By Andrew Malekoff©
A few months ago there was a news report about a guy from upstate New York that was accused of practicing dentistry without a license. The report stated that he operated in his kitchen. In lieu of Novocain he offered his patients a slug of wine to help them through the pain. The story brought back a flood of memories from my childhood. One was a traumatic episode that I re-live to this day every time I sit in a dentist’s chair.
Our family dentist, a family friend, reminded me of the actor Peter Lorre. If you are too young to recall him, Peter Lorre was an Austrian-American actor that often played alongside Humphrey Bogart and was typecast as a creepy, sinister foreigner.
Summer Camp
As a pre-teen in New Jersey many of my friends went away to upstate summer camps in “the mountains.” For me, summer days could be fun or long and boring. I stayed at home and spent my summers at area swimming pools and playgrounds or watching baseball games on television. Except, that is, for one summer in the early 1960’s. My mom asked me if I’d like to go to sleep away camp for a month. I was ecstatic for the opportunity and said, “Yes!”
Along with the news about going away, were sudden car trips to the doctor for a physical exam and a series of shots, and to the dentist to get my teeth checked out. I passed the physical with flying colors and took the shots in stride. I didn't do so well with the dentist. On the car ride home mom told me that I needed sixteen fillings. Sixteen! Since camp was only a few days away she said that I had to get all of the fillings at one time. An appointment was set for the next Friday night at eight-o’clock.
Sitting Down
The dentist’s office was in his house and adjacent to his kitchen where my mom sat from 8 pm to 12 am drinking coffee and chatting with his wife. He did not give me Novocain, which was consistent with my other visits. In-between drillings and fillings Peter Lorre slithered away through a door that led to the kitchen, maybe for a slug of wine reserved for adult patients, while I sat quietly waiting for the next assault. I was stoic. I didn’t complain or shed a tear all night.
I discovered that I could endure lots of pain, and hide it well, on that warm summer night. When we left I didn’t say anything about it to mom or to anyone else.
My only four weeks at sleep away camp were fun. What I remember most though, like it was yesterday, were the four hours in the dentist’s chair.
Standing Up
I recently found a website dedicated to “dental horror stories.” One was written by someone much younger that me, who said that his dentist was always in a rush. One time when he was a kid, he said, the dentist started drilling about 30 seconds after he shot him up with Novocain and before he was numb. He said, “I grabbed him by the wrist and told him to stop.”
He left in a huff and came back five minutes later to finish the job when he was fully numb. Nevertheless, he “fired” the dentist after the encounter, despite the fact that he had a close association with his family. His parents were very upset that he refused to see that dentist again. “I didn’t care,” he said, “he acted like a jerk, and I wasn’t going to stand for it!”
Good for him and for all kids (and others) today that are willing to stand up to authority in the right way and at the right time. Good for you!
This column originally appeared in the Anton newspaper chain on Long Island, New York, October 28, 2009.
By Andrew Malekoff©
A few months ago there was a news report about a guy from upstate New York that was accused of practicing dentistry without a license. The report stated that he operated in his kitchen. In lieu of Novocain he offered his patients a slug of wine to help them through the pain. The story brought back a flood of memories from my childhood. One was a traumatic episode that I re-live to this day every time I sit in a dentist’s chair.
Our family dentist, a family friend, reminded me of the actor Peter Lorre. If you are too young to recall him, Peter Lorre was an Austrian-American actor that often played alongside Humphrey Bogart and was typecast as a creepy, sinister foreigner.
Summer Camp
As a pre-teen in New Jersey many of my friends went away to upstate summer camps in “the mountains.” For me, summer days could be fun or long and boring. I stayed at home and spent my summers at area swimming pools and playgrounds or watching baseball games on television. Except, that is, for one summer in the early 1960’s. My mom asked me if I’d like to go to sleep away camp for a month. I was ecstatic for the opportunity and said, “Yes!”
Along with the news about going away, were sudden car trips to the doctor for a physical exam and a series of shots, and to the dentist to get my teeth checked out. I passed the physical with flying colors and took the shots in stride. I didn't do so well with the dentist. On the car ride home mom told me that I needed sixteen fillings. Sixteen! Since camp was only a few days away she said that I had to get all of the fillings at one time. An appointment was set for the next Friday night at eight-o’clock.
Sitting Down
The dentist’s office was in his house and adjacent to his kitchen where my mom sat from 8 pm to 12 am drinking coffee and chatting with his wife. He did not give me Novocain, which was consistent with my other visits. In-between drillings and fillings Peter Lorre slithered away through a door that led to the kitchen, maybe for a slug of wine reserved for adult patients, while I sat quietly waiting for the next assault. I was stoic. I didn’t complain or shed a tear all night.
I discovered that I could endure lots of pain, and hide it well, on that warm summer night. When we left I didn’t say anything about it to mom or to anyone else.
My only four weeks at sleep away camp were fun. What I remember most though, like it was yesterday, were the four hours in the dentist’s chair.
Standing Up
I recently found a website dedicated to “dental horror stories.” One was written by someone much younger that me, who said that his dentist was always in a rush. One time when he was a kid, he said, the dentist started drilling about 30 seconds after he shot him up with Novocain and before he was numb. He said, “I grabbed him by the wrist and told him to stop.”
He left in a huff and came back five minutes later to finish the job when he was fully numb. Nevertheless, he “fired” the dentist after the encounter, despite the fact that he had a close association with his family. His parents were very upset that he refused to see that dentist again. “I didn’t care,” he said, “he acted like a jerk, and I wasn’t going to stand for it!”
Good for him and for all kids (and others) today that are willing to stand up to authority in the right way and at the right time. Good for you!
This column originally appeared in the Anton newspaper chain on Long Island, New York, October 28, 2009.
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