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.
Monday, November 9, 2009
Saturday, October 31, 2009
TESTIMONY ON GOVERNOR PATERSON'S PROPOSED BUDGET CUTS TO HUMAN SERVICES
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
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
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.
Friday, September 25, 2009
THERE ARE JUST NO WORDS
THERE ARE JUST NO WORDS
By Andrew Malekoff©
Almost a year ago, Marcelo Lucero, an Ecuadorean immigrant, was murdered allegedly by a group of high school boys on a hate-crime spree. Shortly after the murder I was invited to participate as one of six panelists in an online forum sponsored by Newsday.
The panel addressed a number of themes - exposure to prejudice, bigotry and discrimination, the role of the schools and bridging communication gaps. The final theme of the forum was “confronting authority.” This was presented by the editors as follows: “…there are growing suspicions that government institutions have played a major role in perpetuating racial tensions. New allegations that have surfaced since Lucero's death suggest that inadequate attention has been given to patterns of hate-driven violence. Add to that the intensifying trend in law enforcement toward criminalizing and cracking down on illegal immigration. How do community members deal with racism and hate crime when law enforcement and other authorities are seen as complicit in the oppression and violence?”
As I considered this, no prescriptive response came to mind. Instead, a troubling image was jarred loose within me. The image is of a black-and-white photograph that appears on the jacket of a book I read entitled Sons of Mississippi, by Paul Hendrickson. The book is based on that single photograph. It depicts a close-knit gathering of seven Mississippi sheriffs at the University of Mississippi prior to the admission of its first black student James Meredith in 1962. One of the sheriffs is brandishing an axe handle, to the obvious delight of the others. They are anticipating and evidently preparing to participate in the upheaval to come as James Meredith prepares to integrate the University of Mississippi.
Hendrickson’s narrative is culled from interviews, research of documents and literature about the era. Most compelling are his interviews with the sheriffs’ sons and grandsons and with Meredith's son, Joe, regarding their experiences with racism.
Thinking about that photograph makes me wonder about how, 40 years from now, the children of the Long Island law enforcement and other government officials that have, in some cases, turned a blind eye to hate-driven violence or even encouraged it, will look back at the November 9, 2008 murder of Marcelo Lucero. Also how will children and grandchildren of Lucero’s contemporaries view it.
Near the end of the book Hendrickson offers readers one final perspective on the chilling photo of the sheriffs. He quotes the poet and art critic Mark Strand, who reflects on the paintings of Edward Hopper. Strand says, "The shadow of dark hangs over them, making whatever narratives we construct around them seem sentimental and beside the point." This describes precisely how I feel about the murder of Marcelo Lucero as I visualize a photograph taken almost one year ago of seven teen-aged boys from Patchogue, New York in white jumpsuits and handcuffs.
Sometimes there are just no words.
First published in the Anton Newspaper chain on Long Island, New York on September 23, 2009.
By Andrew Malekoff©
Almost a year ago, Marcelo Lucero, an Ecuadorean immigrant, was murdered allegedly by a group of high school boys on a hate-crime spree. Shortly after the murder I was invited to participate as one of six panelists in an online forum sponsored by Newsday.
The panel addressed a number of themes - exposure to prejudice, bigotry and discrimination, the role of the schools and bridging communication gaps. The final theme of the forum was “confronting authority.” This was presented by the editors as follows: “…there are growing suspicions that government institutions have played a major role in perpetuating racial tensions. New allegations that have surfaced since Lucero's death suggest that inadequate attention has been given to patterns of hate-driven violence. Add to that the intensifying trend in law enforcement toward criminalizing and cracking down on illegal immigration. How do community members deal with racism and hate crime when law enforcement and other authorities are seen as complicit in the oppression and violence?”
As I considered this, no prescriptive response came to mind. Instead, a troubling image was jarred loose within me. The image is of a black-and-white photograph that appears on the jacket of a book I read entitled Sons of Mississippi, by Paul Hendrickson. The book is based on that single photograph. It depicts a close-knit gathering of seven Mississippi sheriffs at the University of Mississippi prior to the admission of its first black student James Meredith in 1962. One of the sheriffs is brandishing an axe handle, to the obvious delight of the others. They are anticipating and evidently preparing to participate in the upheaval to come as James Meredith prepares to integrate the University of Mississippi.
Hendrickson’s narrative is culled from interviews, research of documents and literature about the era. Most compelling are his interviews with the sheriffs’ sons and grandsons and with Meredith's son, Joe, regarding their experiences with racism.
Thinking about that photograph makes me wonder about how, 40 years from now, the children of the Long Island law enforcement and other government officials that have, in some cases, turned a blind eye to hate-driven violence or even encouraged it, will look back at the November 9, 2008 murder of Marcelo Lucero. Also how will children and grandchildren of Lucero’s contemporaries view it.
Near the end of the book Hendrickson offers readers one final perspective on the chilling photo of the sheriffs. He quotes the poet and art critic Mark Strand, who reflects on the paintings of Edward Hopper. Strand says, "The shadow of dark hangs over them, making whatever narratives we construct around them seem sentimental and beside the point." This describes precisely how I feel about the murder of Marcelo Lucero as I visualize a photograph taken almost one year ago of seven teen-aged boys from Patchogue, New York in white jumpsuits and handcuffs.
Sometimes there are just no words.
First published in the Anton Newspaper chain on Long Island, New York on September 23, 2009.
Friday, August 28, 2009
PROJECT REBIRTH
PROJECT REBIRTH
By Andrew Malekoff©
In the immediate aftermath of the September 11, 2001 terrorist attack on America, several artists joined together to produce a soft cover book entitled 9/11: Artists Respond. The book of graphic art showcases the artists’ responses to the terror that befell the world. One nine-frame piece by Jeph Loeb and Scott Campbell entitled “Please Stand By…” features a girl of about eight years of age watching cartoons on television. By the third and fourth frames, the image on the screen changes to a live feed of the Twin Towers ablaze. As the little girl stands transfixed, stuffed animal in hand and her face less than 12 inches from the screen, the commentator announces, “We interrupt this program to take you live…” the little girl turns away and calls, “Mommy…” The next three frames show her mother dropping a basket of laundry. Then, with her face contorted in anguish, the mother embraces her daughter to shield her from the unrelenting images. The final frame is a close-up of the little girl asking, “Mommy, when are the cartoons gonna come back on?”
Recently I had the opportunity of viewing another set of images in the form of a moving 30-minute preview of a feature-length documentary film by filmmaker Jim Whitaker that captures rebuilding of the World Trade Center (WTC) and nine people coping with 9/11. Whitaker, who was visiting New York City to attend a wedding at the time of the terrorist attack, is the founder of Project Rebirth, a non-profit initiative aiming to chronicle living history and honor 9/11 victims and first responders.
The film introduces us to a diverse group of nine people, all of whom were impacted by 9 / 11 and agreed to participate in a series of interviews conducted by Whitaker during following years. These individuals include:
• A survivor from an impact floor on the South Tower
• A NYPD officer who oversaw recovery efforts at the Fresh Kills Landfill
• A fireman that survived the collapse of the Towers, but lost his best friend in addition to 343 fellow firefighters
• A teenage boy who lost his mother
• A young woman who lost her fiancé
• A construction worker who lost his brother and assisted with recovery efforts
• A Muslim American woman who became an advocate for religious tolerance
• A volunteer in the recovery effort who later assisted hurricane Katrina survivors
• A man who lost his domestic partner of 14 years and then moved to the West Coast
They generously offer us, and future generations no doubt, the intimate gift of their unfolding grief and resiliency in the face of disaster.
The film is scheduled for release in 2010. In addition to preserving history through this personal record of the long-term grieving process, it is the aim of this film to capture the rebuilding of the World Trade Center. This is accomplished through the use of 12 time-lapse cameras recording 24/7 at the WTC site.
It is the mission of Project Rebirth, beyond creating the documentary, to educate and inform students and future generations, and to help support victims of and first responders to major disasters. A Project Rebirth Center will be developed to integrate and improve on therapeutic, educational and training resources focused on grief and trauma suffered by victims and first responders to major disasters.
I am not sure whether Project Rebirth answers the little girl’s question of, “when are the cartoons gonna come back on?” But I am certain that this astounding work of art will go a long way toward helping survivors and responders of disasters to find their ways out of the darkness.
For more information visit the Project Rebirth website at www.projectrebirth.org.
Originally printed in the Anton Newspapers on Long Island on August 27, 2009.
By Andrew Malekoff©
In the immediate aftermath of the September 11, 2001 terrorist attack on America, several artists joined together to produce a soft cover book entitled 9/11: Artists Respond. The book of graphic art showcases the artists’ responses to the terror that befell the world. One nine-frame piece by Jeph Loeb and Scott Campbell entitled “Please Stand By…” features a girl of about eight years of age watching cartoons on television. By the third and fourth frames, the image on the screen changes to a live feed of the Twin Towers ablaze. As the little girl stands transfixed, stuffed animal in hand and her face less than 12 inches from the screen, the commentator announces, “We interrupt this program to take you live…” the little girl turns away and calls, “Mommy…” The next three frames show her mother dropping a basket of laundry. Then, with her face contorted in anguish, the mother embraces her daughter to shield her from the unrelenting images. The final frame is a close-up of the little girl asking, “Mommy, when are the cartoons gonna come back on?”
Recently I had the opportunity of viewing another set of images in the form of a moving 30-minute preview of a feature-length documentary film by filmmaker Jim Whitaker that captures rebuilding of the World Trade Center (WTC) and nine people coping with 9/11. Whitaker, who was visiting New York City to attend a wedding at the time of the terrorist attack, is the founder of Project Rebirth, a non-profit initiative aiming to chronicle living history and honor 9/11 victims and first responders.
The film introduces us to a diverse group of nine people, all of whom were impacted by 9 / 11 and agreed to participate in a series of interviews conducted by Whitaker during following years. These individuals include:
• A survivor from an impact floor on the South Tower
• A NYPD officer who oversaw recovery efforts at the Fresh Kills Landfill
• A fireman that survived the collapse of the Towers, but lost his best friend in addition to 343 fellow firefighters
• A teenage boy who lost his mother
• A young woman who lost her fiancé
• A construction worker who lost his brother and assisted with recovery efforts
• A Muslim American woman who became an advocate for religious tolerance
• A volunteer in the recovery effort who later assisted hurricane Katrina survivors
• A man who lost his domestic partner of 14 years and then moved to the West Coast
They generously offer us, and future generations no doubt, the intimate gift of their unfolding grief and resiliency in the face of disaster.
The film is scheduled for release in 2010. In addition to preserving history through this personal record of the long-term grieving process, it is the aim of this film to capture the rebuilding of the World Trade Center. This is accomplished through the use of 12 time-lapse cameras recording 24/7 at the WTC site.
It is the mission of Project Rebirth, beyond creating the documentary, to educate and inform students and future generations, and to help support victims of and first responders to major disasters. A Project Rebirth Center will be developed to integrate and improve on therapeutic, educational and training resources focused on grief and trauma suffered by victims and first responders to major disasters.
I am not sure whether Project Rebirth answers the little girl’s question of, “when are the cartoons gonna come back on?” But I am certain that this astounding work of art will go a long way toward helping survivors and responders of disasters to find their ways out of the darkness.
For more information visit the Project Rebirth website at www.projectrebirth.org.
Originally printed in the Anton Newspapers on Long Island on August 27, 2009.
Saturday, August 8, 2009
REFORM PLAN LEAVES CHILDREN AND ADOLESCENTS BEHIND
REFORM PLAN LEAVES CHILDREN AND ADOLESCENTS BEHIND
By Ronda Fein, PhD
First published: Saturday, August 8, 2009, Albany Times Union
In his very articulate July 27 commentary, "It's not reform when it hurts the poor," Andrew Malekoff expresses concern about the state Office of Mental Health and the state Health Department pursuing a "reform" plan that will leave a significant number of children and adolescents without access to mental health care.
The plan will assure continued access to care only to children and families with Medicaid fee-for-service insurance coverage but not to families that have no insurance, or insurance with limited mental health coverage. Families struggling with serious emotional challenges will have trouble finding help if not covered by Medicaid fee-for-service. Clinics and mental health care providers will not be able to continue to accept the low rates offered by Medicaid managed-care carriers and families will not be able to access help.
Anyone who has been through a period of time with a child who is seriously depressed, anxious or behaviorally challenged knows how it affects every facet of one's life.
Our society has moved toward a very misguided view of treatment for mental health issues as being provided in a pill, mainly as a result of pharmaceutical companies' marketing efforts. Medication may be helpful but there is no substitute for the intensive work provided by community clinics, which can target the whole family.
As Mr. Malekoff suggests, the Office of Mental Health must also restore and enhance local assistance funding, which includes a partnership among local and state government, local community and client-consumers for specialty children's outpatient mental health clinics that serve non-Medicaid fee for service clients. Low- and middle-income families deserve access to this care, which is often provided by high quality community-based mental health clinics.
Ronda Fein, Ph.D.
Saratoga Springs
The writer is a licensed clinical psychologist in private practice.
By Ronda Fein, PhD
First published: Saturday, August 8, 2009, Albany Times Union
In his very articulate July 27 commentary, "It's not reform when it hurts the poor," Andrew Malekoff expresses concern about the state Office of Mental Health and the state Health Department pursuing a "reform" plan that will leave a significant number of children and adolescents without access to mental health care.
The plan will assure continued access to care only to children and families with Medicaid fee-for-service insurance coverage but not to families that have no insurance, or insurance with limited mental health coverage. Families struggling with serious emotional challenges will have trouble finding help if not covered by Medicaid fee-for-service. Clinics and mental health care providers will not be able to continue to accept the low rates offered by Medicaid managed-care carriers and families will not be able to access help.
Anyone who has been through a period of time with a child who is seriously depressed, anxious or behaviorally challenged knows how it affects every facet of one's life.
Our society has moved toward a very misguided view of treatment for mental health issues as being provided in a pill, mainly as a result of pharmaceutical companies' marketing efforts. Medication may be helpful but there is no substitute for the intensive work provided by community clinics, which can target the whole family.
As Mr. Malekoff suggests, the Office of Mental Health must also restore and enhance local assistance funding, which includes a partnership among local and state government, local community and client-consumers for specialty children's outpatient mental health clinics that serve non-Medicaid fee for service clients. Low- and middle-income families deserve access to this care, which is often provided by high quality community-based mental health clinics.
Ronda Fein, Ph.D.
Saratoga Springs
The writer is a licensed clinical psychologist in private practice.
Wednesday, July 29, 2009
IT'S NOT REFORM WHEN IT HURTS THE MIDDLE CLASS AND WORKING POOR
It's not reform when it hurts the poor
By ANDREW MALEKOFF
First published in print: Monday, July 27, 2009, Albany Times Union
More low- and middle-income families than ever are in need of low-cost, high-quality community-based mental health care. Yet, the state Office of Mental Health, along with the state Health Department, is aggressively pursuing a "reform" plan that will assure continued access to care only to children and families with Medicaid fee-for-service insurance coverage. This will leave a significant number of children and adults in the lurch.
This clinic reform plan sets up a mental health service delivery system that will no longer assure access to care for children, regardless of their parents' ability to pay.
This represents a dramatic departure from New York's statutory responsibility to make sure our most vulnerable citizens -- our children -- get care, regardless of their family's economic status.
Clinic reform signals movement away from a universal model of care to one that will discriminate against underinsured middle-class and working-poor families. Because of the lack of parity between higher rates paid by government and those paid by commercial insurers, many children with what seems like adequate health insurance coverage will no longer receive behavioral health care services from community clinics.
Community clinics are the last bastion in addressing the needs of children and adolescents with serious emotional disturbances. Private psychotherapists, with rare exception, will not provide the labor-intensive work necessary to properly serve children and families struggling with serious emotional disturbances.
One step forward would be for the Health Department to pressure commercial Medicaid managed-care carriers to increase their rates to match Medicaid rates. A second step would be to do the same with commercial insurers.
As community-based clinics void contracts with underpaying commercial insurers, as they are sure to do, families will be denied service if they are unable to pay the full cost. Commercial carriers that cannot demonstrate an "adequacy of network" can and should have their licenses revoked.
Consumers must be educated about these issues so that they can join the fight now and later, when denied services because their carrier cannot offer them an adequate network of care.
Last but not least, the Office of Mental Health must restore and enhance local assistance funding, also known as deficit financing -- a partnership between local and state government, the local community and client-consumer -- for specialty children's outpatient mental health clinics that serve a significant proportion of non-Medicaid fee for service clients. If implemented in its current design, the clinic restructuring plan will guarantee only narrowly-defined treatment for those with Medicaid fee-for-service eligibility. Clinic reform is certain to increase the marginalized role of middle-class and working-poor families in society.
Action must to be taken now to modify the course of clinic reform, before it is too late.
Andrew Malekoff is executive director of the North Shore Child and Family Guidance Center in Roslyn Heights and a member of the state Office of Mental Health group developing the New York State Children's Plan.
By ANDREW MALEKOFF
First published in print: Monday, July 27, 2009, Albany Times Union
More low- and middle-income families than ever are in need of low-cost, high-quality community-based mental health care. Yet, the state Office of Mental Health, along with the state Health Department, is aggressively pursuing a "reform" plan that will assure continued access to care only to children and families with Medicaid fee-for-service insurance coverage. This will leave a significant number of children and adults in the lurch.
This clinic reform plan sets up a mental health service delivery system that will no longer assure access to care for children, regardless of their parents' ability to pay.
This represents a dramatic departure from New York's statutory responsibility to make sure our most vulnerable citizens -- our children -- get care, regardless of their family's economic status.
Clinic reform signals movement away from a universal model of care to one that will discriminate against underinsured middle-class and working-poor families. Because of the lack of parity between higher rates paid by government and those paid by commercial insurers, many children with what seems like adequate health insurance coverage will no longer receive behavioral health care services from community clinics.
Community clinics are the last bastion in addressing the needs of children and adolescents with serious emotional disturbances. Private psychotherapists, with rare exception, will not provide the labor-intensive work necessary to properly serve children and families struggling with serious emotional disturbances.
One step forward would be for the Health Department to pressure commercial Medicaid managed-care carriers to increase their rates to match Medicaid rates. A second step would be to do the same with commercial insurers.
As community-based clinics void contracts with underpaying commercial insurers, as they are sure to do, families will be denied service if they are unable to pay the full cost. Commercial carriers that cannot demonstrate an "adequacy of network" can and should have their licenses revoked.
Consumers must be educated about these issues so that they can join the fight now and later, when denied services because their carrier cannot offer them an adequate network of care.
Last but not least, the Office of Mental Health must restore and enhance local assistance funding, also known as deficit financing -- a partnership between local and state government, the local community and client-consumer -- for specialty children's outpatient mental health clinics that serve a significant proportion of non-Medicaid fee for service clients. If implemented in its current design, the clinic restructuring plan will guarantee only narrowly-defined treatment for those with Medicaid fee-for-service eligibility. Clinic reform is certain to increase the marginalized role of middle-class and working-poor families in society.
Action must to be taken now to modify the course of clinic reform, before it is too late.
Andrew Malekoff is executive director of the North Shore Child and Family Guidance Center in Roslyn Heights and a member of the state Office of Mental Health group developing the New York State Children's Plan.
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