Monday, November 9, 2009

LONG ISLAND BUSINESS NEWS ON CHILDREN'S MENTAL HEALTH

Long Island Business News

Pushing for parity

Commentary by Andrew Malekoff

Published: November 2, 2009, page 20A

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 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 these critical services. At the same time, Gov. Paterson has proposed cutting local assistance dollars for behavioral health services.

The erosion of local assistance funding in conjunction with 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.

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. 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 afford to offer the labor-intensive work necessary to properly serve families that are struggling with serious emotional disturbances.

I call on New York State, in conjunction with local governments, to restore and enhance rather than slash local assistance funding – a partnership between local and state government, the local community and the 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.

Andrew Malekoff is executive director and chief executive of North Shore Child and Family Guidance Center, in Roslyn Heights.

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