THE DAWNING OF THE MENTAL HEALTH WALMART

THE DAWNING OF THE MENTAL HEALTH WALMART

Submitted to the New York Nonprofit News 12/6/14

Andrew Malekoff, Executive Director / CEO, North Shore Child and Family Guidance Center, Roslyn Heights, NY

New York State's scorched earth policy against mid-size and smaller community-based mental health centers and middle-class children and families has come to fruition on Long Island. Recently PSCH, a $100 million NYC-based agency led by a number former OMH officials, decided to let go of the mental health clinics of two long-standing and highly reputable Long Island-based agencies that they took-over just a few years ago with the blessing of OMH. Pederson Krag and Peninsula Counseling Center's (PCC) mental health programs are gone or on their way out, left to be scooped up by other willing suitors. My friend and colleague the late Herb Ruben, a true mental health advocate who led and built PCC during a 50-year period, must be rolling over in his grave.

OMH has been encouraging mergers (aka takeovers) for years. In this case, two deeply-rooted organizations with more than a combined 100 years on Long Island have seen their mental health services thrown to the wind to be picked up and absorbed elsewhere, never to retain what took the better part of a century to build, a strong, trusted and undeniable presence in the local community.

This is the dawning of the age of the Mental Health Walmart. We are in early stages of a sad time of proliferating Medicaid mills, where children and adolescents with mental health problems will be shuffled along a conveyer of would-be evidence-based care administered by fee-for-service workers with no time to address crisis situations or to make even adequate collateral contacts with schools and other relevant people in the children’s lives. Middle-class families are being pushed out of the so-called “system transformation” process and poorer families are seeing the quality of care erode into to a series of half hour, revenue-maximizing, individual sessions.

The transition from a gold standard to a bronze standard of care is well underway. And, this is happening at the same time that almost $6.5 billion is being thrown at the Medicaid-driven acronym-of-the-year DSRIP – Delivery System Reform Incentive Program, a hospital-conglomerate-run initiative with the admirable goal of reducing emergency room visits and hospital readmissions, for Medicaid patients, of course. Another $1.2 billion is being made available for capital projects.

The other acronyms receiving mere millions are the $7 million to CTAC – Children’s Technical Assistance Center that trains agencies how to best serve Medicaid clients and send those with private insurance packing.  And, most recently on board is the $30 million to VAP – Vital Access Provider initiative aimed at helping agencies that are on life support to find ways to become fiscally self-sustaining on a diet of Medicaid-only clients or take steps to be taken over as Pederson Krag and Peninsula before them. And, oh yes, there is another acronym I almost forgot to mention. That is OT – Overtime. According to NYS Comptroller Tom DiNapoli, the New York State Office of Mental Health spends $100 million annually on overtime expenses.

At North Shore Child and Family Guidance Center, founded in 1953, the only specialty children’s mental health agency on Long Island, we have not received an increase in our Article 31 contract funding in more than 30 years.  If not for our community supporters we would have disappeared long ago, along with our sister agencies. A very small percentage of the billions being spent could make a difference and would go a long way to sustaining needed children’s mental health services on Long Island. But all appeals continue to fall on deaf ears, from the governor to the legislators to the commissioners.

Hello, hello, anyone out there! Does anyone in Albany care?