Both nonprofit organizations providing behavioral health services to local youths will be taken over in the coming weeks by an Arizona agency, Tucson-based Valle del Sol, contracted by the New Mexico Human Services Department.
TeamBuilders, which serves hundreds of children in Northern New Mexico, announced Friday (July 19) it would no longer serve behavioral health services clients enrolled in Medicaid after the middle of next month.
These moves follow a decision by the state to suspend Medicaid payments to 15 behavioral health service providers in June after an undisclosed audit allegedly found more than $36 million in fraud across the agencies.
The changes proposed by the Human Services Department could impact hundreds of Taos County children currently receiving counseling, treatment foster care and behavioral management support among other services.
Officials at Easter Seals El Mirador, which operates Casa de Corazón in Taos, were informed of the state’s plans during a meeting Tuesday (July 23) with government officials and representatives from Valle del Sol.
The Human Services Department accused the organization of breaching its contract to provide care when Casa de Corazón furloughed staff after their suspension from Medicaid, chief operating officer Patsy Romero told The Taos News.
Easter Seals El Mirador would receive $150,000 to continue providing care for the next two weeks while Valle del Sol and the state implement a transition plan, Romero said. She questioned, however, the timeline proposed for the still-developing takeover.
“This is a 45-day process,” Romero said. “They have not thought it out.”
Romero also questioned whether Valle del Sol would be able to provide the same services currently offered by Easter Seals El Mirador if the Arizona agency does not have certificates to operate in New Mexico. “That provider cannot do what we are doing,” Romero said. “You cannot provide behavioral management services unless you are certified and you cannot get certified overnight. It is an extensive process.”
It was also unclear how patient files or personnel materials could be transferred to the Tucson-based nonprofit if Easter Seals El Mirador remained under a criminal investigation, the chief operating officer added.
The state’s plans still left as many as one hundred of Casa de Corazón’s Taos clients in limbo, according to staff.
“From a therapeutic standpoint, we are in a various precarious position because we cannot tell them what is going to happen,” said quality management coordinator Dorothy Forbes.
Despite pledges from the state that care would continue uninterrupted throughout the Medicaid suspension and subsequent criminal investigations into the audit’s findings, Forbes said services have already been affected.
“What the Human Services Department said was not going to happen is happening,” Forbes said.
Earlier this month, 65 local children enrolled in behavioral health services at Casa de Corazón saw care disrupted by furloughs at the agency.
Forbes added there was greater uncertainty now that the other local behavioral health service provider, TeamBuilders Counseling Services, Inc., will no longer see Medicaid patients after mid-August.
“There is nowhere to send them,” Forbes said.
TeamBuilders appealed for state officials to restore funding at least temporarily. The “good cause” application cited the lack of alternatives for many clients such as those residing in Taos County. The TeamBuilders board decided to sever its contract with the state altogether after that application was denied.
TeamBuilders CEO Shannon Freedle told The Taos News he hoped the one-month notice would help facilitate the transition proposed by the state. There have been few details, he said, regarding the state’s plans to ensure clients will continue to receive services as the Arizona agencies contracted by the Human Services Department assume the caseloads of providers like TeamBuilders.
“The ball is in their court. They promised continuity of care,” Freedle said. “Our hope is that we will be engaged and able to participate in an effective transition process.”
Providers and the parents of patients who spoke to The Taos News said they had received few details from the state indicating how such a process might proceed or what it might entail for the agencies involved.
The Human Services Department assured the Arizona nonprofits contracted to take on various roles at affected behavioral health service providers across the state would retain or rehire most of the staff at organizations like Casa de Corazón.
“Our transitional agencies will hire back all providers,” spokesman Matt Kennicott told The Taos News, adding that the Arizona contractors would be offering new management and oversight. “We are working to maintain that consumer-clinician relationship.”
Staff at Valle del Sol declined to comment to The Taos News and referred questions to Kennicott. None of the other four Arizona providers returned requests for comment.
Kennicott said that agencies had overseen similar transitions. “Between the 5 organizations, they have completed a total of 15 transitions similar to this or in instances where the other agency was purchased,” Kennicott wrote in an email to The Taos News, though he declined to elaborate on details of specific plans.
“Each of these transitional agencies is a registered business in New Mexico and has the necessary licensing in place to provide management of services in state,” the spokesman added.
The audit itself raised questions from state auditor Hector Balderas. His request to examine the report from Massachusetts-based Public Consulting Group was denied by the Human Services Department which also refused to comply with a district court order to allow Balderas to inspect the audit Monday (July 22).
“We are abiding by the Attorney General’s wishes to not release the audit so as not to harm their investigation,” Kennicott said.
The Human Services Department referred all 15 behavioral health service providers included in the audit to the Attorney General’s Office which had previously indicated the process of reviewing each case could take months.