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Notes from the field: CMS Call discussing NM Behavioral Health

Some highlights from the Aug. 28, 2013 CMS listening call to hear from behavioral health consumers on the disruption of service due to HSD process of Medicaid funding freeze and bringing in AZ takeover companies.

  • 27 callers were heard.
  • Callers were told not to discuss the “fraud” issue.
  • Many consumers noted that the timing and method of the call was not accessible to most consumers of behavioral health services (working parents, non-English speakers, children, homeless persons, persons in jail or in the juvenile justice system.  Others complained about the lack of outreach to let people know about the call other than email or facebook postings.
  • Callers noted that a quarter of the time for consumers to give their input was taken by HSD defending their actions or countering with their actions to resolve issues.
  • Stories from across the state painted some of the vivid picture of the disruption of services that has taken place, including not being able to get appointments and medications. Many parents reporting disruptions of service for their children.  Lack of contracts by new AZ provider agencies with psychologists who can prescribe medications.
  • Many consumers noted that consumers and their communities were “scared”, “frightened and threatened" by the type of actions taken by HSD. Some described the HSD action as a dangerous future precedent.
  • Consumers complained they received no notification or explanation of changes either from HSD or the new providers. Had to learn about it word of mouth or in the media.
  • One therapist whose takeover situation is down from 12 to 3 therapists for several thousand clients says they now have to do new intake forms which take up to 2 hours.  This results in long waits until this process is completed.
  • Various callers discussed behavioral health professionals either leaving rural areas or the state because of the HSD takeover process.  Two referred to the “ripple effect” across NM and its communities.
  • Callers from Native American communities noted that their communities would be hardest hit both by the disruption of service and the decrease in providers in NM.
  • Various callers called for HSD to “change direction,” restore previous provider agencies, etc.
  • Several callers outlined impact on frontier communities where services are already precarious.
  • Several callers discussed the lack of contracts with BMS workers so children who needed these services couldn’t be in school.
  • An attorney noted that assessments for infants in state care were not happening in her affected area so parents couldn’t start the process to get their children back - with a disastrous effect on family.
  • Callers talked about disruption leading to potential hospitalization and reliance on ER services that didn’t resolve issue. One caller talked of dual diagnosis person who is in a nursing home because of lack of services – this is not an appropriate place for care.
  • A psychologist from one of the pueblos discussed cultural competency and that NM was very different from AZ in cultures and poverty despite the AZ takeover entities’ claims to the contrary. Gave clear examples from tribal and Hispanic traditional societies where it takes extended time of years in these communities to gain real insight into the cultural issues.  Said that bringing in AZ agencies was in fact saying culture doesn’t matter. 
  • One caller called on HSD to put boots on the ground in the affected communities and hold community forums.  When HSD said they would do so with 6 months, the caller deemed that was not acceptable.
  • One caller: “Government has failed consumers and I don’t know how you can sleep at night.”

  

If people have crisis situations, they should call:  855-662-7474

If people have care coordination issues, they should call 866-660-7185

 

Also, active Facebook groups for this issue can be found here:

1) New Mexico Rising Up - https://www.facebook.com/nmrising 

2) Save Behavioral Health https://www.facebook.com/SaveBehavioralHealthNM

 

- Notes by Barbara

Health Action

You are not invincible! (Sorry.... but true.)

Young Invincibles Video Contest, by USGOVHHS
 

This fall, many young Americans will have more health insurance options available to them than ever before as the Affordable Care Act (ACA) begins allowing individuals to enroll in new subsidized health insurance plans. Young Invincibles and the U.S. Department of Health & Human Services have created a competition that will tap into the creativity and energy of young Americans while raising awareness about the new law and encouraging young people to take advantage of the benefits of health insurance.

With a prize pool worth up to $30,000, and over 100 prizes to be won, this is your opportunity to shine! Cash prizes will be awarded to the creators of the best videos in three distinct categories; so whether you’ve got a talent for short films, writing a great song, or designing an entertaining video infographic, you can be a winner! Click the links above to learn more about each of the categories and how you can participate.

Videos can be submitted during the five-week period starting on Monday, August 19th. A public voting period will follow to help determine the Finalists in each category, and a final round of voting and judging will determine who takes home the Grand Prize. The Young Invincibles website has all the juicy details.

Health Action

Let us not abandon our own

 

La Llorona
La Llorona, source here
 

With increasing amazement and sorrow, I’ve watched unfold the behavioral health saga in New Mexico with the Arizona takeover of 15 long standing New Mexico provider non-profits. Last week, I sat in a meeting where some of the targeted providers provided a very different story than has surfaced in public coverage of these events. Affected consumers also shared their stories.

I came away with the sense that we have only seen the tip of the iceberg the impact this misadventure has and will have for many decades on communities and people’s lives across New Mexico. One person described it as the tsunami that will touch every corner of New Mexico. 

Even if we reversed everything tomorrow, our fragile support system for vulnerable children and adults touched by mental health issues, their families, their schools, workplaces, etc. can never be the same.  Skilled providers in our rural communities have already begun leaving the state.  Providers seeking certification in the new health plans and MCO’s are withdrawing their applications saying they don’t want to work in such a climate of uncertainty and lack of loyalty to patients and employees. Charges of intentional criminality have shattered both providers and clients.   

Those of us who know New Mexico’s deeply rooted communities whose fabric goes back centuries and, in the case of tribal communities, millennia, wonder how it was conceivable to bring in entities from another state.  Others ask where was the state and their oversight vendor in providing training and management guidance. Still others ask what agendas are at play.

But what stills the heart are the stories, the people’s stories – the grandmother of an eight-year old who has lost her BMS worker just before school starts and as her behavior escalates, puts her fist through a wall; the anguished mother who watches the increasing anxiety and regression of her 23 year old son with schizophrenia as his provider non-profit changes are happening… the stories go on.

New Mexico must act quickly to create opportunities for state and federal decision makers to hear from those affected by this surging crisis and investigate the process that brought us this crisis and learn from it.  Brakes need to be placed on a process that has ignored due process, respect and client safety.   

The basic therapeutic relationship as well as public stewardship is one of trust.  Trust has been broken at many levels and action needs to be taken immediately. Because if not, we are all doomed in New Mexico to collectively become La Llorona: condemned to wander New Mexico forever asking, donde estan mis hijos, where is the mother with postpartum depression, the father on the road to recovery, the young teens without hope, the veterans who could not forget? Where are those we are pledged to protect?  Like La Llorona, we have abandoned our own for the promises and resources of outsiders.  New Mexico, New Mexico, can we change our looming fate of becoming La Llorona?

 

- Barbara Webber, HANM Executive Director

Health Action

Communications 101: Make it Make Sense

There are as many explanations of the Affordable Care Act these days as there are types of eggs in a natural foods store. While I am thrilled to see so many people working to spread the word, often the information varies depending on who is producing the content. And sometimes not all information out there is very user-friendly.

There is one simple solution that I think would immediately make most ACA content easier to read: replace the word "Exchange" with the word "Marketplace."

The reason is this.

What comes to mind when you hear the term “Exchange”? I think of stock markets or trading beads in the Trobriand Islands. Unfortunately, neither of these are close to what the new health insurance option will look like. So it's understandable when people are confused after hearing about the new "Exchange" that is starting in October.

Now try the word “Marketplace.” What images does this word bring to mind? Are farmer's markets, grocery stores, or craft fairs high on your list? NOW you're getting closer to what the new health insurance Exchange - ahem, Marketplace - will be like.

So read on to this infographic, but keep in mind that what we're actually talking about is a consumer-friendly, easy-to-use marketplace where you can shop for health insurance. 

Health Action

Big day, big opportunity

Whew! What a whirlwind over the past 24 hours. I'm still reeling from the Texas state senate being the most exciting thing to watch ever, and now SCOTUS taking the side of equality. But we're still looking ahead to even more exciting opportunities to make history!

With 96 days left until open enrollment for the new Health Insurance Marketplace, hundreds of thousands of people still don't know what's coming. I had a chat with local comedian Sarah Kennedy last night about what all this means for New Mexico. Check us out!

Health Action

We partied on for health care

 

Danielle unveils the new website, by danielle

 

So, first things first: you found our new website. Good job!

We've been working hard since January to get a new website up and running, and finally got a chance to celebrate with our Website Launch party on May 16th. The event was a blast, and we had everyone from Senator Shendo to enthusiastic community members in attendance.

 

You can find the key features of the website on your own by surfing through, but I'd like to draw your attention to a few key parts:

  • People from across the state can submit the stories of their experiences with health care, as well as read others' stories on our interactive map view.
  • 5 separate RSS feeds let you stay up-to-date on the news items that matter most to you - for example, the Marketplace Watch tracks all implementation of the new Health Insurance Marketplace (aka "Exchange") in New Mexico.
  • You can now donate ONLINE, including setting up recurring donations, by clicking on the "Donate" button on the top of each page.

Our goal with the new website is to create a central place where all information on health care reform in New Mexico is stored. Health reform is a huge, complicated topic, and communication about all the different parts can get tricky. We are working hard to make this site easy to read, easy to navigate, and easy to find all of the information that matters most to you.

Folks at our website launch party enjoyed live music by Sherri Gonzales, Ron Hale, and Marsha McMurray-Avila, including a new song on health reform that Marsha wrote specially for the event.

Sherri Gonzales and Ron Hale performing some live blues music, by danielle
 

Special thanks goes to our sponsors: La Montañita Co-Op, Flying Star Cafe & Satellite Coffee, and The Grove Cafe & Market. And a big thank you to all those who attended and made this a great event!

Lots of opportunities to meet new people at our website launch party, by danielle
Health Action

It’s a New Day for Health Care in New Mexico!

 

May 3, 2013 at 10:00 a.m. found me driving through miles of pecan groves in the southern part of New Mexico. I was heading to our first event in a series we are hosting this summer through Health Action New Mexico (HANM) – cultural learning events aimed at educating communities about their new health insurance options under the Affordable Care Act. I wasn’t sure what to expect; believe it or not, it can be difficult to get people really excited about attending an event where the main topic is health insurance.

Our first of these events was scheduled to be held in San Miguel, a small village in Doña Ana county. I was pleasantly surprised to be greeted by over a hundred happy, welcoming faces ready to celebrate the Cinco de Mayo and to hear about the new day for health care in New Mexico! This wonderful turnout was an accomplishment by our co-host for the event, Concilio Campesino, a non-profit organization that offers community services to residents in southern New Mexico. 

The program first included upbeat, celebratory music to commemorate el Cinco de Mayo, with snacks of fresh fruit, baked breads, coffee, and bottled water.  Then, after welcoming of all present by the Concilio Campesino team, we did a brief power point presentation narrated in Spanish of what is going to be offered under the Medicaid Expansion and the Health Insurance Marketplace.  This presentation was done as an introduction, providing the basics of who is eligible, how to apply, and how to get help if a challenge occurs during enrollment.  We also introduced a plan where there will be a "You Are Not Alone" committee of local community leaders to help those applying for enrollment in either of these programs to overcome any obstacle that they may encounter during enrollment periods.    There was a question and answer period as a part of the presentation, where many participants got to ask their questions.   We closed the event with a return to the celebratory activities of music and interchange among friends.

The event was fantastic. In addition to the great turnout, I appreciated the welcoming attitude that was displayed by the participants, the enthusiasm to learn about the health options being described, the interest to ask questions, and the commitment expressed by many to share information with others.  

 

Our key strategy in these community events is to share factual information presented in the simplest, most actionable terms possible. We want to empower residents to determine for themselves who may be eligible, how to apply, and how to get help if necessary. Everyone took home checklists that walk through seeing if you are eligible for these new health insurance options, so they can take their health care into their own hands.

25% of New Mexicans are uninsured or underinsured. 170,000 people will be eligible for Medicaid Expansion in New Mexico, and another 200,000 for the Health Insurance Marketplace (aka “Exchange”). At HANM we are hosting these cultural learning events throughout the state to bring greater awareness of these health insurance options to communities around the state. If our first event is any indication, people are excited to find out about the changes that are occurring, and empowered to make healthy decisions for themselves and their families.

Our next event is Saturday, May 18th, 3:00 – 5:00pm, at the Beatrice Martinez Senior Center: 730 Vietnam Veterans Memorial Park Road, Española NM. Featuring live musical guest Miguel Timoteo. Come celebrate a new day in health care with us!

Health Action

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