Valencia Counseling CEO hopes appeals court will make a decision soon

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Things are going as well as can be expected, said Sam Vigil, CEO and founder of Valencia Counseling Services.

The agency is one of 15 nonprofit agencies that had Medicaid funding suspended after an audit ordered by the New Mexico Human Services Department was completed in June.

The audit claims more than $36 million in Medicaid funds has been erroneously or fraudulently paid to the 15 providers during the last three years.

The payments were suspended, as required under federal law, said Matt Kennicott, spokesman for the Human Services Department.

About 80 percent of the VCS's funding comes from Medicaid, Vigil said, and serves about 2,000 clients in three counties.

He is holding out hope that something will change in the next two to three weeks before he has to turn over operations of Valencia Counseling's three offices to an Arizona company.

The state reached an agreement with several Arizona companies for management of the 15 agencies. The contract is capped at $17 million, Kennicott said.

Valencia Counseling was among eight agencies named in the audit that asked a federal judge to reverse the state's decision to freeze the payments.

Last Thursday, U.S. District Judge M. Christina Armijo denied the request. The providers wanted payments to resume while the state gives them a hearing to address the allegations of billing problems.

The audit findings have not been made public nor disclosed to the agencies. They have been turned over to the New Mexico Attorney General's office for investigation.

So far, aside from the audit summary which gave specific findings but did not identify individual providers, Vigil said he hasn't been given any information from the audit.

Vigil said the eight agencies are appealing Armijo's decision.

"We are hoping for a favorable decision there so we can keep going until the investigation is over," Vigil said.

He said the agencies were also hoping the attorney general would either start clearing or charging the nonprofits with "whatever we have committed allegedly," Vigil said.

In a previous interview, Kennicott indicated the Arizona companies would be used for management purposes only and would not be bringing in their own clinicians to serve patients directly.

Vigil said from what he has seen of other agency takeovers, such as Families & Youth, Inc., of Las Cruces, the Arizona companies have indicated they will rehire everyone except management.

"I know in Las Cruces, they hired mostly everybody," he said.

Vigil said he didn't know which of the five Arizona companies would come in to manage VCS.

"I guess that will be triggered when we run out of money," he said.

Vigil said a local provider, such as the nearby First Choice, would have been a better decision than going out of state for management services.

The therapists and clinicians at Valencia Counseling are getting a lot of reaction from their clients, Vigil said.

"They are all very stressed. We are trying to do our best to protect them," he said. "Our consumers are suffering from mental illness and this makes it so much worse."

At this point, Vigil said some of his staff are uncertain if they will stay, even if the replacement company offers them a position.

"Some of them have been with me for more than 30 years. They are really struggling with what's happening," he said. "Most of them, including myself, are retirement age. It's really hard to accept that we've built this agency and to see it crumble at the end of your career."

Vigil said he has heard rumblings of a special legislative session being called to address the issue, but called it a long shot.

"I wish (New Mexico Human Services Department) would have honored our good-cause request to keep our funding going. They just sent out a letter saying, 'We will not honor your request,'" Vigil said. "I hope, and maybe I'm hoping for too much, but hopefully the appeals court will take this on quickly. We are running out of time."


-- Email the author at jdendinger@news-bulletin.com.