Editorial: Heroes and big questions after Tri-County closes

Posted 8/29/18

Taos, Colfax and Union counties faced a behavioral health crisis when Tri-County Community Services suddenly announced it would close with barely two weeks notice.Everyone from the state's top …

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Editorial: Heroes and big questions after Tri-County closes

Posted

Taos, Colfax and Union counties faced a behavioral health crisis when Tri-County Community Services suddenly announced it would close with barely two weeks notice.

Everyone from the state's top officials to healthcare providers seemed caught off guard, not by the announcement, but by how quickly it folded. More than 1,000 clients wondered how they would get the treatment, counseling, medication and life help they had come to rely on from Tri-County services.

Tri-County staff along with other nonprofit providers gamely stepped in and pulled off a miracle in two weeks. Working with state Behavioral Health Services, they made sure most of the Tri-County programs were transferred to another organization and that clients will get the help they need.

It was a Herculean effort. The Tri-County CEO skipped out before the final days, and the board seemed largely absent. But core staff worked to the bitter end in the office helping clients. Ted Wiard at Golden Willow Retreat and Tammy Jaramillo at Taos County deserve extra accolades for coordinating efforts.

Still, we are left with many disturbing questions and deep concerns that no one with the state or the now-defunct Tri-County seem willing to answer clearly, simply and transparently. We worry whether the groups that are taking over this sudden influx of hundreds of clients midway through the year will avoid the financial troubles that helped sink Tri-County.

We ask the following questions because it is imperative that no one, least of all the clients most in need, are caught off guard again.

• Why wasn't there a backup plan already in place in case Tri-County failed? The most recent board and the state BHS have known for more than a year the nonprofit was in deep financial trouble. While the latest board was admirable in its efforts to save the organization, they and the CEO should have had a contingency plan in place. People's lives and well-being were at stake.

• Of all the bills it needed to pay, why didn't Tri-County ensure the electronic records company was satisfied, so providers and patients could get medical records before the doors closed for good? After all providers and patients are legally entitled to those records. And did Tri-County not keep old-fashioned paper records it could simply have handed over?

• Who the heck was really keeping tabs on Tri-County? Did the state not offer the help it should have or was its offer of help ignored? Behavioral Health Services director Wayne Lindstrom laid the blame on everyone at Tri-County, from its office staff (they didn't know how to bill properly, so bills were denied by insurance companies), to its CEO to its board (they didn't know what they were doing). The state says it can't tell a private organization how to manage its affairs, but it can offer technical assistance on business and clinical service management.

• Did Falling Colors, a third-party contractor hired by the state to manage Medicaid payments, have a part in the Tri-County fiasco? Were they doing their job properly and ensuring Tri-County was receiving its payments in a timely manner?

• Finally, will Valle del Sol, one of the primary behavioral health organizations told by the state to take on part of Tri-County's load, stick around? It is worth remembering Valle del Sol was one of five Arizona based behavioral health organizations paid millions by the state to take over after Gov. Susana Martinez's administration in 2013 upended existing services by wrongly accusing providers of fraud and freezing their Medicaid payments.

All of the providers were exonerated, but most closed in the meantime due to financial stress. Three of the five Arizona companies left after only a couple of years.

Valle del Sol threatened to leave in December 2016 due to "high rates of claims denial and continuing deterioration of rates paid for services," according to a state report.

And once again, the impending termination of services "was totally unanticipated," said the state at the time.

Valle del Sol laid off staff and shrank services until April 2017 when they struck a deal with the state and received some extra money to stay.

So, we ask, if the going gets tough and their payments are mishandled or cut, will Valle del Sol stick around? Will the state be again caught off guard? What will happen to all of their new counselors and therapists? What will happen to all of their new patients?

Who, ultimately, really has the backs of some of the most vulnerable people in our state?

It is time for state lawmakers and whoever is elected governor in November to step in and take a hard look at New Mexico's entire behavioral health system - to ensure proper checks and balances are in place, to ensure public funds are wisely used and to make sure people most in need aren't left in the lurch.

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