February 25, 2021
Below is the verbal testimony I just delivered to the members of the Joint Legislative Budget Committee examining the Governor’s Health and Medicaid proposals.
I’m Lauri Cole, the executive director of the NYS Council for
Community Behavioral Healthcare, a statewide membership
association representing mental health and substance use providers
across New York. I’m here to ask for your assistance.
The BH system of care is hanging by a thread. We have been
ravaged by 3 concurrent public health disasters with the Opioid
Epidemic, increasing rates of suicide, and COVID 19. New York
families and communities are devastated. The system of care
designed to provide prevention, treatment and rehabilitative options is
sorely underfunded and in crisis. The demand for our services far
outpaces our ability to respond and every data point indicates it is
going to get worse.
There should be no cuts to the mental health and substance use
disorder / addiction systems of care. Instead, we are proposing smart
investments. This year, we have requests that would return
resources that belong to our system of care to include a set aside of
funds from the state’s Healthcare Transformation Fund
account consistent with Assemblyman Gottfried’s and Senator
Rivera’s bills, A264 and S2531, a request that all state aid funding
withholds be restored, and that the state honor its’ commitments to
reinvest savings from our system back into it.
Behavioral health services were transitioned to Medicaid Managed
Care beginning in 2015. The law and policy of this state is
clear: managed care savings from our system of care go back to our
system of care. Before BH services transitioned, stakeholders were
very concerned about money being siphoned out of the system by
plans for their profits. We spent countless hours working in
collaboration with state leaders on language for statute and guidance
documents to ensure transparency in this process, and for managed
care savings to accrue to the system of care from which it came. At
that time, there was ample evidence in literature and historical
context for us to have concerns about the siphoning off of funds once
we transitioned to Medicaid Managed Care. We saw it coming, we
put in safeguards, but the state has again left the chicken coop open
for the foxes.
To date, we haven’t received a single document of substance in
response to four FOIL requests filed in the early fall via our counsel,
seeking information that should be readily available if the state was
holding the health plans accountable for meeting behavioral health
expenditure targets and Medical Loss Ratios (MLRs) established as
part of the transition to Medicaid Managed Care. Our written
testimony goes in to great detail as to the information we believe we
are entitled to, and where the law supports our requests for
transparency. The requested documents would reveal whether the
health plans hit those targets and MLRs, or whether they owe monies
back to the BH system. So, the questions is this: What is the state
hiding? Could it be that they allowed the plans to retain those funds?
We are calling for a full accounting of the managed care savings from
our system of care as well as shortfalls in behavioral health
expenditures by the Medicaid health plans, and we are asking for
your help to ensure that these funds are properly invested back for
essential behavioral health services, needed now more than ever.