Federal review will examine access to behavioral health care

Process prompted by events that happened in 2013

Hannah Grover
Farmington Daily Times
  • The New Mexico Human Services Department suspended Medicaid payments to 15 nonprofit behavioral health care providers statewide in 2013 .
  • Local providers say there is not enough access in San Juan County to behavioral health care.
U.S. Sen. Tom Udall

FARMINGTON — There's a waiting list more than a month long for a potential client to get an appointment to see a counselor or therapist at local behavioral health care centers, local providers say.

Most of the members of New Mexico's congressional delegation hope a review by the U.S. Department of Health and Human Services Office of the Inspector General will help more people get treatment. The review process will begin this fall. It will examine access to behavioral health care for Medicaid patients in New Mexico, according to a press release from the delegation that included every senator or representative from the state except for U.S. Rep. Steve Pearce.

The elected officials cited changes in behavioral health care resulting from a 2013 audit as reasons for the investigation in the press release. The New Mexico Human Services Department suspended Medicaid payments to 15 nonprofit behavioral health care providers statewide in 2013 citing "credible allegations of fraud."

Many of those providers closed their doors or were replaced by out-of-state providers. All 15 have since been cleared of the allegations.

U.S. Sen. Tom Udall, D-New Mexico, released a statement calling the 2013 shakeup a "manufactured crisis that has had tragic consequences for children and families struggling with mental illness, behavioral health issues and substance abuse."

Barbara Charles, administrative director of San Juan Health Partners, a local health care provider connected to the San Juan Regional Medical Center, said in an email the shakeup had limited effects on the care in San Juan County because many of the providers that closed were not located within the area. However, Rick Quevedo, the CEO of Desert View Family Counseling, a local behavioral health care provider, said Desert View received an influx of patients afterward and was already struggling to meet demand.

The review could help assess and evaluate needs and develop both short- and long-term plans to address those needs, Charles said.

Quevedo said he does not know if the federal review will bring about the needed changes to improve access to behavioral health care. Other studies have not triggered needed changes, he said.

"They gather a lot of data and identify a lot of needs, but nothing ever comes of it," he said.

Quevedo and Charles said there is not enough access in San Juan County to behavioral health care.

While Desert View Family Counseling accepts insurance and also receives grant funding to provide services, Quevedo said about 80 percent of the patients rely on Medicaid. He said those patients struggle with housing and having their material needs met.

"To put their mental health at the top of the list is really a challenge for them," he said.

Charles said an increased demand for services also has created challenges.

"Many communities, including San Juan County, are struggling to ensure adequate and timely behavioral health services are available," she said. "Children and adolescents in particular are significantly underserved. Our ability to meet growing behavioral health needs has an immediate impact on the health and safety of our community. "

Quevedo said San Juan County needs an adolescent crisis center. Teenagers needing help are currently sent to crisis centers in Albuquerque or Las Cruces.

A lack of funding is another challenge to decreasing wait times. Charles and Quevedo said the county needs more behavioral health providers to meet demand.

"We need more access and capacity for behavioral health services which is driven by the need for more behavioral health providers," Charles said. "In order to recruit and retain more behavioral health providers, improvements in funding and reimbursement for these services across all age groups and all types of payers is paramount."

Many of the people who need mental health care hesitate to schedule appointments, Quevedo said.

"There's such a stigma behind mental health that some people don't want to take the step," he said.

Quevedo said wait lists and the struggles to pay make it harder for people to receive the help they need.

"A lot of these folks need to have been seen yesterday," he said.

Hannah Grover covers government for The Daily Times. She can be reached at 505-564-4652.