A hearing on the lawsuit brought by eight behavioral health service providers against Governor Susana Martinez's administration is set for 9:00 a.m. tomorrow, July 17 in Federal District Court in Albuquerque. The group is suing to have funding restored by the state and Human Services Cabinet Secretary Sidonie Squier. Squier abruptly halted all funding for the providers several weeks ago in the wake of an audit the department says was necessary after reports of alleged fraud and misuse of Medicaid funding.
Several other providers of behavioral health services in New Mexico are preparing to shut down after their funding was also frozen because the state audit allegedly found evidence of fraud and mismanagement by a total of 15 organizations.
The panic was palpable in the Rio Arriba County Commission chambers. About 75 families grilled Human Services Department division director Karen Meador about the agency's abrupt cutoff of funding for children's behavioral health services like suicide and drug addiction counseling.
Meador responded that services for behavioral health clients would continue under new contracts with Arizona companies, and she said that jobs would not be lost.
But Lauren Reichelt says she's concerned about service continuity, something that has been lost before in Rio Arriba County, at great financial and human cost. Reichelt is the county's Health and Human Services Director.
“If these services are taken away from us, then that falls on Assistant County Manager Trujillo and myself to increase our jail services, and that’s not where we want to be providing services," Reichelt said. She added that the county wants to instead provide services in local schools and clinics and keep people healthy in their homes.
Many of the providers who have had their funding cut say the state hasn't provided all the details on what fraud is alleged to have occurred and by whom.
Patsy Romero is chief operations officer for the nonprofit Easter Seals El Mirador, which serves several hundred clients in northern New Mexico. “We do need accountability and we do need reviews," she agreed, "but those should be transparent and above board and you should be working with the people. If you think we’re doing something wrong, tell us what we’re doing wrong. We deserve our due process, we want to know.”
Romero and other provider groups like the National Council for Behavioral Health claim they are victims of a "witch hunt" by HSD. The Association's president and CEO is quoted in a Santa Fe New Mexican article by Steve Terrell today as saying providers feel targeted:
"The state has tried them and found them guilty in the press, and the patients they serve and the staff they employ are understandably frightened and angry."
Many behavioral health providers in New Mexico receive a significant portion of their budgets from the state's Medicaid program and they don't have cash reserves to keep providing services without these funds.
Casa de Corazon site manager Ambrose Baros asked HSD's Karen Meador to reveal next steps for those in limbo. The organization provides behavioral health services through its nonprofit Easter Seals El Mirador. “You froze the funds three weeks ago," he said angrily, "so you know closures are coming. How is there going to be enough time for a fundamental transition plan for our community and our members and our families that we care so much about?”
Meador reminded people at the meeting that HSD has contracted with five behavioral health companies in Arizona that she said are going to help fill the gap.
“We have identified providers to be on-call, should they be needed so that services continue and don’t get disrupted." Meador continued, "No one has been paid, yet. They are ready to serve, should we need them. They’re also ready to hire people locally to continue the service you’re providing.”
But critics of this proposal say a demand for culturally sensitive services has been a recurring issue in northern New Mexico, where a majority of clients are Hispanic and Native American. Meador tried to assure the crowd that the Arizona companies set to take over services are culturally competent. As for details of the audit, Meador said that’s impossible while the AG investigates. “What I’d like to be able to tell you is everything," she said, "But once we refer to the attorney general, we’re not allowed to give you the details.”
Of the 15 providers whose funding has been cut, eight are suing the State of New Mexico, seeking restored funding through a federal court injunction. Their attorney is Patric Hooper of Los Angeles, who told Milan Simonich of Texas-New Mexico Newspapers that his clients all have more than 30 years of service to New Mexico.
Darren, a bespectacled teen who waited patiently for his turn to speak and didn’t want to give his last name at the community meeting, said his experiences as a client working with the staff at Casa de Corazon have really helped him. “Before then, I used to bring weapons to school," Darren said softly, "and I used to be experimenting in drugs. And now I’m doing better. We started a garden and everyone commented and made me feel good. That showed me that I don’t need to do all that stuff anymore.”
The 15 nonprofits whose state funding was frozen serve 30,000 New Mexicans with behavioral health and drug abuse issues. State officials say jobs will be preserved, but providers say the cuts would put 360 people out of work in northern New Mexico alone.
A summary of the state's audit says New Mexico overpaid providers $36 million dollars in Medicaid payments. The audit also allegedly found evidence of fraudulent activity by certain executives.
The Human Services Department has forwarded the audit results to the attorney general’s office and they say they can't predict how long the investigation will take.
But federal Medicaid administrators say the state did not have to abruptly halt providers' funding. Bryant Furlow of New Mexico In Depth quotes Tony Salters, spokesman for the Centers for Medicare and Medicaid Services:
"States do not have to suspend payments if they can show good cause for not doing so," said Salters.
Behavioral health and Medicaid law expert Adam J. Falcone said that the move by Governor Susana Martinez's administration could largely "cut off access to mental health services," and added, "This is drastic stuff. It's very unusual."