MONEY VS. MENTAL HEALTH

September 20, 2018 at 5:00 am

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 September 19, 2018.

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>>> A NEW FRONT ON THE BATTLE
AGAINST MENTAL HEALTH DISORDERS
AND DRUG ADDICTIONS EMERGES.
PARODY FEDERAL AND STATE LAW
MANDATES THAT FOR MENTAL HEALTH
ADDICTION AND PHYSICAL HEALTH
COVERAGE BUT HEALTH INSURERS
MIGHT NOT BE FOLLOWING THE LAW.
RIGHT HERE IN NEW YORK A LOCAL
NONPROFIT MENTAL HEALTH CARE
AGENCY, NORTH SHORE CHILD AND
FAMILY GUIDANCE CENTER,
CONDUCTED A STUDY ON THE ISSUE.
THEIR FINDINGS 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 WHO
PAYS FOR THEIR SERVICES.
JOINING US TODAY IS THE CEO OF
NORTH SHORE CHILD AND FAMILY
GUIDANCE CENTER, WHERE THE STUDY
WAS CONDUCTED, ANDREW MALEKOFF
AND SOCIAL WORKER CARRIE ELLER.
I'D LIKE TO WELCOME YOU BOTH TO
THE PROGRAM.
FIRST I JUST WANT TO GET AN
UNDERSTANDING AS TO HOW THIS
STUDY EVEN CAME INTO EXISTENCE.
>> WELL, JUST TO PROVIDE A
LITTLE CONTEXT, IN 2008 THE
MENTAL HEALTH PARODY AND
ADDICTION EQUITY ACT PASSED, IT
WAS A BIPARTISAN BILL SPONSORED
BY TWO SENATORS, ARCH
CONSERVATIVE PETE DEMENECHI AND
ARCH LIBERAL PAUL WELLSTONE BOTH
OF WHOM HAD EXPERIENCED THE
IMPACT OF MENTAL ILLNESS IN
THEIR FAMILIES.
SO THIS LAW THAT WAS 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 PROHIBITION
AGAINST LIMITING THE NUMBER OF
VISITS THAT SOMEONE WITH A
MENTAL HEALTH ISSUE MIGHT HAVE,
PROHIBIT DIFFERENTIALS IN TERMS
OF COPAYS OR IN TERMS OF
DEDUCTIBLES, AND IN ADDITION TO
THAT, 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 AN INCREDIBLY
WHAT WAS IT THAT TIPPED YOU OFF
THAT SOMETHING WAS AMISS?
>> SO ANDY ALLUDED TO THE IDEA
THAT YOU CALL YOUR INSURANCE
COMPANY, YOU ASK THEM WHO TAKES
MY PLAN, WHO IS COVERED BY MY
INSURANCE.
THEY WILL GIVE YOU A LIST OF
NAMES AND YOU CALL THE PROVIDERS
AND SOMETIMES THEY ARE NO LONGER
IN THE NETWORK OR THEY ARE 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, SO WE DO HAVE OPEN ACCESS,
BUT WHAT WE KNOW IS 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,
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 SO DIFFICULT
THAT SOMETIMES PEOPLE RETREAT.
>> THAT'S AN INCREDIBLY
IMPORTANT POINT AND I ACTUALLY
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 EFFECT
FIRSTHAND.
>> I WORK IN THE COMMUNITY ALL
OF NASSAU COUNTY, I SERVICE, YOU
KNOW, MANY POPULATIONS THAT HAVE
STRUGGLED TO ACCESS MENTAL
HEALTH CARE UNTIL THEY FINALLY
FOUND THEIR WAY TO NORTH SHORE
CHILD AND FAMILY GUIDANCE
CENTER, AND I ALSO HAVE A UNIQUE
PERSPECTIVE BECAUSE I'M ALSO THE
SISTER OF A TEEN WHO STRUGGLES
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.
SO WHEN THEY FINALLY DO YOU HAVE
SUCH A SHORT WINDOW TO ENGAGE
THESE 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 IF
THEY 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
MEDICAID, NOT UNINSURED.
IN NEW YORK STATE MOST OF THE
FOCUS FROM THE GOVERNMENT IS ON
MEDICAID.
YOU KNOW, I WILL TELL YOU A VERY
BRIEF STORY.
MANY YEARS AGO I WAS IN THE
OCEAN, I LIVE IN LONG BEACH, AND
I SAW THREE GIRLS DRIFTING OUT
TOWARDS THE JETTY.
I SWAM OUT AND I PUT MY ARMS
AROUND THEM.
IN A VERY SHORT PERIOD OF TIME
THE LIFEGUARDS CAME AND HELPED.
CAN YOU IMAGINE IF I SWAM OUT TO
THESE THREE LITTLE GIRLS, MAYBE
SIX, SEVEN, EIGHT YEARS OLD, I
WAS SO CLOSE I COULD SEE THEIR
FRECKLES AND IF INSTEAD OF
PUTTING MY ARMS AROUND THEM I
TREADED WATER JUST A FEW FEET
AWAY AND SAID, HEY, GIRLS, DO
YOU HAVE MEDICAID?
THAT'S THE SITUATION THAT WE
FACE RIGHT NOW IN NEW YORK
STATE.
SO IT'S THE MIDDLE CLASS AND THE
WORKING POOR THAT SUFFER MOST
FROM THE IMPACT OF NOT BEING
ABLE TO ACCESS CARE THROUGH
THEIR COMMERCIAL INSURANCE.
>> WELL, LISTEN, I WANT TO THANK
YOU BOTH FOR JOINING US ON THE
PROGRAM AND OF COURSE FOR
CONDUCTING THIS STUDY THAT EVEN
ALERTED US TO THE PROBLEM TO
BEGIN WITH.
>> OKAY.
THANK YOU.
>> THANK YOU SO MUCH.
>> THANK YOU.

Mutual of America PSEG

Funders

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