COMMENTARY: A terrible tragedy that affects thousands of vulnerable children and adults in need of often life-saving mental health and substance abuse treatment continues to play out in slow motion in New Mexico. Crucial health services for residents now are withering away as the fourth of only five behavioral providers in our state, Valle del Sol of Arizona, announced last month that it will leave New Mexico. For those who are on the receiving end, it is intolerable.
This dire situation for people began, it may be recalled, three and a half years ago when Gov. Susana Martinez’s administration leveled charges of overbilling and fraud against the state’s then-15 longstanding treatment providers. Even though the Attorney General’s Office subsequently cleared all of them of the allegations, the state has never returned more than $11 million in payments owed to the providers from that time. As a result, most of the providers went out of business and treatment access across the state was disrupted or taken away altogether.
The provision of behavioral health services in New Mexico has never recovered. The companies from Arizona brought in to replace pre-2013 providers now all have left, except for one.
In the current legislative session, I will try at least to ensure that this situation, created by groundless allegations, never occurs again. My due process legislation will guarantee that providers who stand accused of fraud by the state receive the opportunity to review the allegations made against them, and the chance to respond to those allegations in a hearing, and in district court. That opportunity did not exist by law in 2013.
That is fine for the future. But what about today? Many questions linger.
At a hearing of the Legislative Finance Committee recently, state Human Services Department Secretary Brent Earnest stated that the $11 million owed to providers for services rendered had been kept in a non-interest bearing account by OptumHealth, the state’s contractor overseeing payments to providers from 2009 to 2013. Despite a lawsuit to have those funds paid out to the providers, the state has now placed them in a court registry, where they sit idle.
Ten of New Mexico’s former providers are accusing OptumHealth in a lawsuit that it fabricated the fraud allegations in order to keep the $11 million. A federal court will decide if that is true. But it is worth noting that OptumHealth on another occasion was fined by the state $1 million for failing to pay providers for their services. It is all very concerning.
How many people with mental health disorders are going without treatment for their conditions today because of the disruption of services caused by the 2013 takeover? We don’t know, but you can bet it’s a lot.
We are going into the fifth year of this mental health and substance abuse services crisis, and still there is no interest from the governor’s office to solve it. New Mexico needs direct answers to get to the bottom of this mess. Most importantly, we need to get the state’s behavioral health system back on its feet, delivering treatment to vulnerable children and adults. Much more leadership from the executive would help make it so.
Mary Kay Papen, D-Las Cruces, represents District 38 in the New Mexico Senate, where she is president pro tem.