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12 behavioral health firms face takeover

ALBUQUERQUE, N.M. — At least a dozen of the 15 behavioral health nonprofits that were scrutinized in a special audit this year will be taken over by Arizona providers, the Human Services Department confirmed on Thursday.

The HSD had not previously been specific about the number, saying only that decisions about new management were being made case by case.

Ten of the 12 certain takeovers are already underway or about to get underway, HSD officials said.

The department also said, at a meeting of the New Mexico Behavioral Health Interagency Purchasing Collaborative, that the Arizona providers brought in by HSD are hiring, on average, 90 percent of the staffs of the New Mexico nonprofits they’re assuming control of.


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All staffers except those in executive management are being offered jobs, said Diana McWilliams, director of HSD’s Behavioral Health Services Division.

The HSD in late June froze Medicaid money for services for mental illness and substance abuse to all 15 nonprofits that were audited, saying there was overbilling, mismanagement and possible fraud.

The local providers protest that they weren’t told what they did wrong – the audit has not been publicly released – nor were they given a chance to correct it.

There also have been complaints about disruptions in services, although the administration of Gov. Susana Martinez says the transition to new managers is going smoothly.

“We are working on making sure consumers are safe, and that services are in place throughout the network,” McWilliams told the interagency group, which is aimed at improving mental health and substance abuse services.

McWilliams said some consumers are fearful not because of a lack of services, but because they don’t understand information they’re getting from providers.

“The existing agencies that have a pay hold in place have not always given the correct information to consumers,” McWilliams said.

One small provider, Service Organization for Youth in Raton, had its Medicaid funding restored and is getting technical assistance and training from one of the Arizona providers.


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The HSD is still weighing its options with Santa Fe-based Presbyterian Medical Services and Albuquerque-based Youth Development Inc.

Presbyterian Medical Services, which has 40 sites around the state, is an “integrated care model” with a special federal designation that provides Medicaid-funded physical health and dental health, as well as behavioral health, making it more difficult for a behavioral health agency to take it over.

Presbyterian Medical Services CEO Steven Hansen said the agency has been in talks with HSD and La Frontera, one of the Arizona providers, trying to figure out “the most realistic way to improve what PMS is doing in behavioral health, and comply with what HSD wants, and use the expertise of La Frontera.”

“The train’s kind of left the station. … It’s not comfortable, but we’re trying to make the most of it,” Hansen said.