MONEY VS. MENTAL HEALTH ON LONG ISLAND

Despite legislation meant to address the issue, a new study by North Shore Child & Family Guidance Center in Roslyn Heights, Long Island, has found that it’s increasingly difficult to find mental and addiction healthcare specialists who accept commercial insurance. But there’s hope. Find out about a new project designed to help those in need.

Aired on June 19, 2018.

TRANSCRIPT

> A NEW FRONT ON THE BATTLE AGAINST MENTAL HEALTH DISORDERS AND DRUG ADDICTIONS EMERGES.

PARITY FEDERAL AND STATE LAW MANDATES FOR ADDICTION AND HEALTH CARE COVERAGE BUT HEALTH INSURERS MIGHT NOT BE FOLLOWING THE LAW.

RIGHT IN NEW YORK A LOCAL NON-PROFIT MENTAL HEALTH CARE AGENCY NORTH SHORE CHILD AND FAMILY GUIDANCE CENTER CONDUCTED A STUDY.

THEY FIND THAT MENTAL HEALTH AND ADDICTION CARE IS GETTING DIFFICULT TO ACCESS.

THEY CLAIM THAT COMMERCIAL INSURERS ARE SHORT CHANGING THE INDUSTRY AND YOU, THE ONE PAYING FOR THE SERVICE.

JOINING US TODAY IS THE CEO OF NORTH SHORE CHILD AND FAMILY GUIDANCE CENTER WHERE THE STUDY WAS CONDUCTED.

ANDREW AND SOCIAL WORKER KERRY ELLER.

FIRST I WANT AN UNDERSTANDING HOW THE STFD CAME INTO EXIST ZBLOONS JUST TO PROVIDE A LITTLE CONTEXT IN 2008 THE MENTAL HEALTH PARITY AND ADDICTION EQUITY ACT PASSED.

IT WAS A BIPARTISAN BILL SPONSORED BY TWO SENATORS, ARCH CONSERVATIVE PETE ADMIN ITCHY.

AND PAUL WELL STONE.

BOTH OF WHOM EXPERIENCED THE IMPACT OF MENTAL ILLNESS IN THEIR FAMILIES.

AND SO THIS LAW PASSED IN 2008 MADE IT VERY CLEAR AND PROHIBITED TREATING THE CARE OF PEOPLE WITH MENTAL ILLNESS OR ADDICTIONS DIFFERENTLY THAN PEOPLE WITH PHYSICAL HEALTH PROBLEMS.

AND WHAT THAT MEANS IS THAT THERE WOULD BE A PROHIBITITION AGAINST LIMITING THE NUMBER OF VISITS WITH A MENTAL HEALTH ISSUE MIGHT HAVE.

PROHIBIT DIFFERENTIALS IN TERMS OF CO-PAYS OR DEDUCTABLES.

AND IT MANDATED THAT INSURANCE CARRIERS WOULD HAVE AN ADEQUATE NUMBER OF PROVIDERS IN THEIR NETWORK FOR PEOPLE SO THAT THEY COULD EASILY ACCESS AFFORDABLE CARE WITHIN THEIR GEOGRAPHIC AREA.

THAT'S IMPORTANT.

WHAT WAS IT THAT TIPPED YOU OFF THAT SOMETHING WAS AMISS.

ANDY ALAUDED TO CALLING THE INSURANCE COMPANY AND ASKING THEM, WHO TAKES MY PLAN, WHO IS COVERED BY MY INSURANCE?

THEY GIVE YOU A LIST OF NAMES.

AND YOU CALL THE PROVIDERS AND SOMETIMES THEY'RE NO LONGER IN THE NETWORK OR ONE OF THE FEW PROVIDERS THAT DOES STAY ON THE NETWORK AND SO THEY HAVE LONG WAITS FOR CLIENTS TO BE ABLE TO ACCESS THE CARE.

AT NORTH SHORE CHILD AND FAMILY GUIDANCE CENTER WE TURN NO ONE AWAY FOR INABILITY TO PAY.

UM-HUM.

WE DO HAVE OPEN ACCESS.

BUT WE KNOW THAT PEOPLE WITH THESE KIND OF ISSUES, MENTAL ILLNESS AND SUBSTANCE USE DISORDERS ARE ALSO DEALING WITH STIGMA, WHICH MEANS THAT THEY HAVE A VERY DIFFICULT TIME PICKING UP THE PHONE, ASKING FOR HELP, WAITING DAYS, WEEKS AND MONTHS AND SOMETIMES YEARS.

AND SO WHEN THEY FINALLY PICK UP THE PHONE AND THE PERSON AT THE OTHER END SAYS I NO LONGER ACCEPT YOUR INSURANCE, THAT'S SO DEMORALIZING AND DIFFICULT THAT SOMETIMES PEOPLE RETREAT.

THAT'S INCREDIBLY IMPORTANT.

AND I WANT TO BUILD ON THAT FOR MY QUESTION FOR CARRIE.

BECAUSE AS A SOCIAL WORKER I'M SURE YOU'RE SEEING A LOT OF THE EFFECTS FIRST HAND.

WORK IN THE COMMUNE, ALL OF NASSAU COUNTY AND SERVICE MANY POPULATIONS WHO STRUGGLE TO ACCESS HEALTH CARE.

AND I HAVE A UNIQUE PERSPECTIVE BECAUSE I'M ALSO THE SISTER OF A TEEN WHO STRUGGLED WITH MENTAL HEALTH ISSUES AS WELL AS CHEMICAL DEPENDENCY.

AND I CAN ATTEST THAT THE STIGMA ASSOCIATED TO THAT MAKES IT INCREDIBLY DIFFICULT FOR PEOPLE TO REACH OUT FOR HELP.

WHEN THEY FINALLY DO, YOU HAVE SUCH A SHORT WINDOW TO ENGAGE THE CLIENTS SO THEY FEEL COMFORTABLE AND READY TO ACCESS THEIR TREATMENT.

BUT UNFORTUNATELY THAT'S NOT THE CASE WHEN THEY'RE HAVING GREAT DIFFICULTY GETTING CONNECTED TO PROVIDERS WITHIN THEIR NETWORK.

SO, ANDY, WE'VE BEEN TALKING A LOT ABOUT PEOPLE WHO HAVE HEALTH INSURANCE.

BUT I'M WONDERING IF YOU'RE UNINSURED HOW DOES THAT CHANGE THE DYNAMIC OF PEOPLE'S ACCESS TO MENTAL HEALTH CARE?

IF SOMEONE HAS MEDICAID OR APPLY FOR SOMETHING LIKE FOR EXAMPLE CHILD HEALTH PLUS, WHICH MANY DO, THOSE WOULD BE INSURANCES THAT WOULD ALLOW THEM TO ACCESS CARE.

THE PROBLEM IS BECAUSE OF SIGNIFICANT CHANGES IN THE LAST TEN YEARS IN NEW YORK STATE WITH THE WAY THEY FINANCE OUTPATIENT MENTAL HEALTH AGENCIES, THAT MANY OF THOSE AGENCIES HAVE TURNED AWAY COMMERCIAL HEALTH INSURERS AND WILL ACCEPT ONLY MEDICARE, NOT UNINSURED.

AND NEW YORK STATE -- MOST OF THE FOCUS FROM THE GOVERNMENT IS ON MEDICAID P.

> A BRIEF STORY.

I WAS IN THE OCEAN AND I SAW THREE GIRLS DRIFTING TOWARD A JETTY.

I SWAM OUT AND MIGHT ARMS AROUND THEM IN IN A SHORT PERIOD OF TIME THE LIFE GUARDS HELPED.

CAN YOU IMAGINE IF I SWAM OUT TO THE THREE LITTLE GIRLS, 6, 7, 8 YEARS OLD SO CLOSE I COULD SEE THEIR FRECKLES.

INSTEAD OF PUTTING MY ARMS AROUND THEM I TREADED WATER AND ASKED THEM IF THEY HAVE MEDICAID.

THAT'S THE SITUATION IN THE NEW YORK STATE.

IT'S THE MIDDLE CLASS AND WORKING POOR THAT SUFFER MOST FROM NOT ACCESSING CARE THREW THE COMMERCIAL INSURANCE.

I WANT TO THANK YOU YOU BOTH FOR JOINING US ON THE PROGRAM AND OF COURSE FOR CONDUCTING THE STUDY THAT EVEN ALERTED TO US THE PROBLEM.

THANK YOU SO MUCH.

THANK YOU.

THANK YOU.

Funders

MetroFocus is made possible by James and Merryl Tisch, Sue and Edgar Wachenheim III, the Sylvia A. and Simon B. Poyta Programming Endowment to Fight Anti-Semitism, Bernard and Irene Schwartz, Rosalind P. Walter, Barbara Hope Zuckerberg, Jody and John Arnhold, the Cheryl and Philip Milstein Family, Janet Prindle Seidler, Judy and Josh Weston and the Dr. Robert C. and Tina Sohn Foundation.

WNET

© WNET All Rights Reserved.

825 Eighth Avenue

New York, NY 10019