View Single Post
Old 07-19-13, 02:18 AM
SPURSGIRL4Life's Avatar
SPURSGIRL4Life SPURSGIRL4Life is offline
Resident Non-conformist
Join Date: Jun 2006
Posts: 186

Along with other nonprofits in New Mexico offering behavioral health services, we now face our 4th week of payment holds imposed by HSD, results of the audit remain undisclosed, and we continue to be denied due process or the opportunity to take corrective action if needed.

Worse yet, we have been publicly branded as criminals and are being told by HSD that our life’s work will be handed over to Arizona companies. These companies have not been properly vetted, do not have the credentials to provide services in New Mexico, and they are strangers to our communities, the New Mexico system and the people we serve. The transition plan is poorly constructed and will decimate our behavioral health system. New Mexico is paying these companies over $17 million of taxpayer money.

Eighteen years ago, when I was pregnant with my youngest child, my husband Shannon and I started TeamBuilders in Tucumcari. Using the spark of a $10,000 planning grant, we mobilized others to meet the needs of young people impacted by grief, trauma, violence, mental illness and addiction.

Today, TeamBuilders is a designated Children’s Core Service Agency serving 23 historically under-served counties and 15 Native American communities throughout New Mexico. In the past year we served 6,750 of our state’s most vulnerable children and their families, including many children in state custody. We employ over 650 staff and foster parents who heroically work 24/7, responding to crises in homes, schools and detention facilities. We come together to help our communities in times of natural disasters and critical need.

TeamBuilders regularly receives over 30 days of audits per year from state, federal and private entities. None of these audits identified the concerns claimed by the HSD audit. In fact, during the same review period, our agency achieved “exemplary status” for all of our children’s Medicaid programs by CYFD Licensing and Certification Authority; international awards of excellence in our evidence-based multi-systemic therapy program (top 1 percent); and grades of over 95 percent for audits conducted by OptumHealth.

Naturally, we have a lot of questions:

We question Optum’s new algorhythmic software, put to widespread use before it was tested.

We question the agency selection criteria.

We question Public Consulting Group’s 24-point audit tool and the fact that not meeting one of the 24 criteria – a 96 percent compliance rate – constituted failure.

We question why there was no examination of the instrument, the process or the larger system when all 15 agencies failed.

We question Public Consulting Group, which has made a business of promising millions in Medicaid/Medicare recoupment and delivering only a small fraction of the savings.

We question a department that takes drastic action under a veil of secrecy and urgency without seeking first to understand.

And we question a system that could allow this to happen to people and organizations who, for decades, have cared for thousands of New Mexicans with the greatest needs.

Through multiple state administrations, many iterations of managed care, a web of competing regulations and increased demands to do more and more with less and less, the nonprofit providers have remained steadfast in our commitment. We have been the constant. We have been the instruments of change for important initiatives.

Now we are facing annihilation at the hands of a government we have been faithful to.

We welcome an impartial review by the Attorney General’s Office. If this is indeed a legitimate process, we also implore HSD to utilize its discretion to provide an immediate release of funding without contingencies while the investigation takes place.

We are committed to identifying and resolving all concerns, while maintaining continuity of care. Time is of the essence.

And, please, help me explain to my daughter who leaves for college next month, why we must trust this process.
Life can only be understood backwards; but it must be lived forwards.
- Soren Kierkegaard
Reply With Quote