MONEY VS. MENTAL HEALTH

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.

TRANSCRIPT

> 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.

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