State Settles With Behavioral Health Care Providers Gutted By Former Republican Governor; One Act Of Kindness Reveals True Character Of New Mexico Governor Michelle Lujan Grisham

“Behavioral health” can be defined as “the scientific study of the emotions, behaviors and biology relating to a person’s mental well-being, their ability to function in every day life and their concept of self. Behavioral health is the preferred term to “mental health.” A person struggling with his or her behavioral health may face stress, depression, anxiety, relationship problems, grief, addiction, ADHD or learning disabilities, mood disorders, or other psychological concerns. Counselors, therapists, life coaches, psychologists, nurse practitioners or physicians can help manage behavioral health concerns with treatments such as therapy, counseling, or medication.”

Defining Behavioral Health

One of the cruelest things that former Republican Governor “She Who Shall Not Be Named” did was when she ordered an “audit” of mental health services by nonprofits in New Mexico based on questionable information. The audit eventually devastated New Mexico’s behavioral health system.

In June 2013, under the direction of the former Republican Governor, the Human Services Department (HSD) cut off Medicaid funding to 15 behavioral health nonprofits operating in New Mexico. In 2014, more than 160,000 New Mexicans received behavioral health services, with most of those services funded by Medicaid, according to the Human Services Department.

After the audits were completed, the former Republican Administration said that the outside audit showed more than $36 million in over billing, as well as mismanagement and possible fraud. Under the orders of the Republican Governor, Human Services Department agency brought in 5 Arizona providers to take over from New Mexico providers.

In early 2016, following exhaustive investigations, the Attorney General cleared all 15 of the healthcare providers of any wrongdoing and exonerated all of them of fraud. Even though the Attorney General found no fraud and actually cleared the nonprofits of fraud, the damage had been done to the nonprofits. With the Medicaid funding freeze, many of the nonprofits could not continue and just went out of business leaving many patients without a behavioral health service provider. Lawsuits against the state were initiated by many of the mental health care providers.

Three of the five Arizona providers brought in by the previous Republican Administration in 2013 to replace the New Mexico nonprofits pulled out of the state. New Mexico’s mental health system has yet to fully recover.

https://www.abqjournal.com/749923/third-arizona-behavioral-health-provider-to-pull-out-of-state.html

CASES BEING SETTLED

During a July 9, 2019 press conference, Governor Michelle Lujan Grisham announced that her Administration has settled several of the long-running lawsuits involving the states nonprofit behavioral health providers affected by a 2013 Medicaid funding freeze ordered by her Republican predecessor. The lawsuits as a carry-over from the former Republican Governor Administration have now cost the state millions of dollars in taxpayer money that could have been put to better use for essential services.

Negotiated settlement agreements have been reached with at least 3 of nonprofit behavioral health providers affected by a 2013 Medicaid funding freeze. The three providers the state settled with are: Valencia County Counseling Services, The Counseling Center and Hogares.

All 3 behavioral health providers were among 15 mental health nonprofits that had their Medicaid funding cut off by order of the former Republican Governor based on allegations of “potential” overbilling and fraud. The New Mexico Attorney General eventually cleared all 15 of the providers of any wrongdoing following investigations, but many were driven out of the behavioral health business.

Under the terms of the negotiated settlement agreements, the state will pay the Valencia County Counseling Services, The Counseling Center and Hogares nearly $2.7 million in dmages. The 3 providers have agreed to pay the state roughly $191,000. One of the providers will also be able to apply to the state for a reinstatement of its Medicaid provider number. Several of the other behavioral health nonprofits still have active claims under a consolidated lawsuit pending in the Santa Fe First Judicial District Court.

Human Services Secretary David Scrase had this to say about the settlements:

“We are encouraged by the progress made to resolve these cases, and we believe that these settlements are in the best interest of New Mexico and our behavioral health network.”

Notwithstanding the settlements announced, Governor Lujan Grisham said the damage to New Mexico’s mental health system caused by 2013 Medicaid funding freeze ordered by her predecessor affected numerous families and businesses and it will take years to recover from and she said:

“Quite frankly, it’s created such deep holes in the other health care delivery systems in Medicaid … that in fact it’s raised the cost in the private market for health care.”

https://www.abqjournal.com/1338147/settlements-reached-with-three-mental-health-providers.html

GOVERNOR LUJAN GRISHAM’S COMMITMENT TO BEHAVIORAL HEATH CARE

During my early teenage, high school and college years, my family dealt with a member who suffered from very severe, chronic and self-destructive mental illness who never recovered from it until his passing. I will always remember how my father was treated by health care professionals and yes at times law enforcement. Throughout my life and public service career, I made sure I knew how elected officials dealt with behavioral health care issues. When I was a prosecutor, I understood the importance of drug treatment programs and behavioral health programs as an alternative to prosecution and incarceration and returning people to be productive citizens.

In politics, more can be learned about a politician and their character by observing them in private and especially how they treat other people. A little more than 5 years ago, I attended a small fund raiser for then Congresswoman Michelle Lujan Grisham. In attendance was a person who we both knew and dealt with in the past, who was a very vocal critic of both of us in the past, and who we both understood to have mental health issues. Michelle Lujan Grisham, not knowing that I was listening and watching her, had one of her aides approach her and ask her if she wanted the person removed before she started to speak. Her response was quick and sure and it told me more about her than I had ever known. She told her aide to talk to the person, make sure he did not need anything, and then after the event, make sure he got a ride home seeing as the person walked to the event and it would be dark when the event ended. This one act of understanding revealed the true character of an elected official.

COMMENTARY AND ANALYSIS

The former New Mexico Republican Governor never understood the need for mental health services and it was an easy target for her conservative anti government philosophy to freeze Medicaid funding to bring 15 nonprofits to their knees and forcing them out of business. To the former prosecutor, the answer was always increasing penalties and incarceration. It has never been fully reported on how the 5 Arizona Heath Care providers were selected to replace the New Mexico nonprofits. It has also never been revealed to what extent the former Republican Governor was involved with the selection nor what orders her office gave in the selection of the out of state providers.

What is known is that legacy of Republican Governor “She Who Must Not Be Named” is a legacy of shame when it comes to the destruction of New Mexico’s nonprofit mental health care system. Her political wrath and cost cutting measures affected thousands of New Mexico residents in need of mental and behavioral health care services and she simply did not give a damn.

After 8 very long years, New Mexico has a Governor that truly understands the need for effective and critical mental and behavioral health care services. Governor Michelle Lujan Grisham served as Director of New Mexico’s Agency on Aging under Governors Bruce King, Gary Johnson and Bill Richardson. Governor Richardson elevated the position to the state cabinet. In 2004. Lujan Grisham was appointed as New Mexico Secretary of Health where she was a champion for mental health services.

It is now on to cleaning up the many other piles of Republican Elephant dung left by the previous Republican Governor “She Who Must Not Be Named”.

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About

Pete Dinelli was born and raised in Albuquerque, New Mexico. He is of Italian and Hispanic descent. He is a 1970 graduate of Del Norte High School, a 1974 graduate of Eastern New Mexico University with a Bachelor's Degree in Business Administration and a 1977 graduate of St. Mary's School of Law, San Antonio, Texas. Pete has a 40 year history of community involvement and service as an elected and appointed official and as a practicing attorney in Albuquerque. Pete and his wife Betty Case Dinelli have been married since 1984 and they have two adult sons, Mark, who is an attorney and George, who is an Emergency Medical Technician (EMT). Pete has been a licensed New Mexico attorney since 1978. Pete has over 27 years of municipal and state government service. Pete’s service to Albuquerque has been extensive. He has been an elected Albuquerque City Councilor, serving as Vice President. He has served as a Worker’s Compensation Judge with Statewide jurisdiction. Pete has been a prosecutor for 15 years and has served as a Bernalillo County Chief Deputy District Attorney, as an Assistant Attorney General and Assistant District Attorney and as a Deputy City Attorney. For eight years, Pete was employed with the City of Albuquerque both as a Deputy City Attorney and Chief Public Safety Officer overseeing the city departments of police, fire, 911 emergency call center and the emergency operations center. While with the City of Albuquerque Legal Department, Pete served as Director of the Safe City Strike Force and Interim Director of the 911 Emergency Operations Center. Pete’s community involvement includes being a past President of the Albuquerque Kiwanis Club, past President of the Our Lady of Fatima School Board, and Board of Directors of the Albuquerque Museum Foundation.