Valerie Bogart, Senior Attorney of the Legal Services for the Elderly, presented a devastating analysis of the New York State legislation and plan which mandates managed care for Medicaid recipients. She raised substantial issues of access and coverage, particularly for those with special needs because of their age, disability, or mental status. Her remarks amplified on the testimony she developed for her agency which was presented at a recent New York City hearing. The testimony is available from the Legal Services for the Elderly. A more positive picture of the potentials of managed care for Medicaid recipients.
Enrollment is voluntary and there has now been five years of experience with the plan.
Safeguards for patient care are provided through the central office of the plan which contracts with existing community health care centers for care of Medicaid patients on a capitation basis. However, even in an admirable program such as the Bronx Health Care Plan, directed by Maura Bluestone, there are serious gaps, particularly in providing for mental health needs and the care of those with alcoholism and substance abuse. These remain serious issues in managed care and reflect the inadequacies of existing primary care settings, particularly those serving low-income and poor people. Nevertheless, as Robert Gumbs, Executive Director of the NYC Health Systems Agency made clear, the State legislation mandates managed care and leaves no choice for the counties and large cities of New York State. He demonstrated the growth of need and the crisis in providing health care services in New York City.