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
Showing posts with label economy. Show all posts
Showing posts with label economy. Show all posts
Saturday, October 31, 2009
Sunday, November 23, 2008
PRESERVING EMPATHY IN HARD ECONOMIC TIMES
PRESERVING EMPATHY IN HARD ECONOMIC TIMES
By Andrew Malekoff ©
As executive director of the pre-eminent children’s outpatient mental health agency on Long Island, I have grave concerns about the impact of the global economic meltdown on services that address the emotional well being of vulnerable children and their families.
Despite the influence of distinguished legislators with big hearts, big government has treated children’s mental health with little respect over the years. For example, at North Shore Child and Family Guidance Center we have not received an increase in government funding for our core children’s mental health services for the better part of two decades.
In addition, a key factor contributing to declining revenues for children’s mental health services is a poorly regulated managed health care system that is more interested managing costs than managing care, paying a substandard rate for critical services and often denying payment for no good reason.
“The First Hostage of Survival is Empathy”
Beyond anticipated government cuts in human services funding I am concerned about individual and corporate supporters retreating into survival mode. As community activist Paul Tonna warns, “The first hostage of survival is empathy.”
To make up the difference in big government’s neglect and managed care’s scheming, services like ours have relied for decades on the compassion and generosity of community supporters that extend themselves to the cause. It is important to know that these people are more than do-gooders, despite the good that they do.
They are smart and selfish. They are smart because they know that what we do is cost effective, saving tens of millions of taxpayer dollars by keeping troubled kids at home and out of costly institutional settings. They are selfish because they know, as one of them stated, “If your child is not healthy, my child is not safe.”
Beyond these attributes our supporters are empathetic. They look into the eyes of their own children, grandchildren, niece and nephews and feel a deep connection to all children.
The Kindness of Others
Over the years family members and friends have asked me what led to my choosing a career in the human services, intimating that it is not the most lucrative path. My greatest influence was observing the profound impact of the kindness of others during my growing up years.
The father of my childhood friend Rich died in the 1950’s. My friend was six- years-old at the time, decades before “grief counseling” became a part of our lexicon. I lost touch with Rich as we grew older, moved apart and went our separate ways. When his mother Lillian died in 1993 I sent him a note. Some weeks later Rich, who is a physician today, wrote back to me. I saved his letter and I read it from time to time. When I do, it always leaves a lump in my throat. His letter to me starts like this:
“Dear Andy: What a surprise to hear from you! My mom’s death has caused me to spend hours thinking about my childhood. Some of my most fond recollections involve you and your family. Your father was the dad I didn’t have…”
I observed my father and mother and other adults in my family carrying out acts of profound kindness and generosity with no fanfare and without ever the expectation of anything in return, for all the years that I was growing up. I married a woman who came from a similar family, one in which her parents took in their nieces after the death of their mother. Now I have found these people again among our board of directors and community supporters. What they have in common with my family is their empathy.
Preserving Empathy
Government bureaucracies are by definition dispassionate and have no empathy. They have rules and regulations. But, only in tyrannies do they get to run things. One can only hope that the policies that guide their rules are guided by values rooted in the felt needs of real people.
I know that we cannot rely exclusively on government to take care of us. We must rely on one another. If we allow empathy to slip away under cover of economic survival, we are in trouble. The demise of empathy will be the most perilous consequence of the collapsing economy.
Let’s take care to preserve empathy. When all else fails it is all that we have to maintain a humane society.
Originally published in the Anton newspaper chain, Long Island, NY in November, 2008.
By Andrew Malekoff ©
As executive director of the pre-eminent children’s outpatient mental health agency on Long Island, I have grave concerns about the impact of the global economic meltdown on services that address the emotional well being of vulnerable children and their families.
Despite the influence of distinguished legislators with big hearts, big government has treated children’s mental health with little respect over the years. For example, at North Shore Child and Family Guidance Center we have not received an increase in government funding for our core children’s mental health services for the better part of two decades.
In addition, a key factor contributing to declining revenues for children’s mental health services is a poorly regulated managed health care system that is more interested managing costs than managing care, paying a substandard rate for critical services and often denying payment for no good reason.
“The First Hostage of Survival is Empathy”
Beyond anticipated government cuts in human services funding I am concerned about individual and corporate supporters retreating into survival mode. As community activist Paul Tonna warns, “The first hostage of survival is empathy.”
To make up the difference in big government’s neglect and managed care’s scheming, services like ours have relied for decades on the compassion and generosity of community supporters that extend themselves to the cause. It is important to know that these people are more than do-gooders, despite the good that they do.
They are smart and selfish. They are smart because they know that what we do is cost effective, saving tens of millions of taxpayer dollars by keeping troubled kids at home and out of costly institutional settings. They are selfish because they know, as one of them stated, “If your child is not healthy, my child is not safe.”
Beyond these attributes our supporters are empathetic. They look into the eyes of their own children, grandchildren, niece and nephews and feel a deep connection to all children.
The Kindness of Others
Over the years family members and friends have asked me what led to my choosing a career in the human services, intimating that it is not the most lucrative path. My greatest influence was observing the profound impact of the kindness of others during my growing up years.
The father of my childhood friend Rich died in the 1950’s. My friend was six- years-old at the time, decades before “grief counseling” became a part of our lexicon. I lost touch with Rich as we grew older, moved apart and went our separate ways. When his mother Lillian died in 1993 I sent him a note. Some weeks later Rich, who is a physician today, wrote back to me. I saved his letter and I read it from time to time. When I do, it always leaves a lump in my throat. His letter to me starts like this:
“Dear Andy: What a surprise to hear from you! My mom’s death has caused me to spend hours thinking about my childhood. Some of my most fond recollections involve you and your family. Your father was the dad I didn’t have…”
I observed my father and mother and other adults in my family carrying out acts of profound kindness and generosity with no fanfare and without ever the expectation of anything in return, for all the years that I was growing up. I married a woman who came from a similar family, one in which her parents took in their nieces after the death of their mother. Now I have found these people again among our board of directors and community supporters. What they have in common with my family is their empathy.
Preserving Empathy
Government bureaucracies are by definition dispassionate and have no empathy. They have rules and regulations. But, only in tyrannies do they get to run things. One can only hope that the policies that guide their rules are guided by values rooted in the felt needs of real people.
I know that we cannot rely exclusively on government to take care of us. We must rely on one another. If we allow empathy to slip away under cover of economic survival, we are in trouble. The demise of empathy will be the most perilous consequence of the collapsing economy.
Let’s take care to preserve empathy. When all else fails it is all that we have to maintain a humane society.
Originally published in the Anton newspaper chain, Long Island, NY in November, 2008.
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