The integration of peer support services into outpatient mental health settings is a crucial step toward expanding mental health care accessibility in New York. Mindful Living LCSW PLLC has been tirelessly working to become a CORE-designated provider, allowing us to provide much-needed services under Medicaid. However, despite our credentials, experience, and commitment to serving the community, we continue to face systemic barriers that threaten to limit our ability to provide these essential services.
A Broken System: Small Practices Left Behind
Large agencies, often referred to as the “Big Five,” receive the majority of financial support and staffing resources, enabling them to meet the rigorous demands of Medicaid billing and compliance. Meanwhile, smaller private practices like ours struggle to navigate the labyrinth of regulations and requirements, which were primarily designed with these large agencies in mind.
Our practice has been repeatedly pushed away from becoming a CORE provider, instead being encouraged to seek alternative funding sources. While securing diverse funding is a reasonable approach, the alternatives suggested by the Westchester County Department of Community Mental Health (DCMH) do not align with our mission or the needs of our target population. The ability to provide peer support services through Medicaid is essential for the long-term sustainability of our practice and for addressing the increasing demand for mental health care in our community.
Holding the System Accountable
If DCMH continues to push private practices toward alternative funding sources instead of CORE certification, they must ensure that these funding streams are both viable and sustainable. Otherwise, small providers will be left in an untenable position—unable to offer services due to financial constraints and restricted by the very system designed to expand mental health care access.
The reluctance to integrate smaller agencies into the CORE provider framework is not just an administrative issue; it is a public health concern. The demand for mental health services in New York is higher than ever, and every qualified provider should have the opportunity to contribute to meeting this need. Blocking capable and credentialed providers from obtaining CORE certification limits service expansion and ultimately harms those seeking care.
A Call for Fairness and Transparency
Mindful Living LCSW PLLC is committed to working alongside the government to establish a framework that allows private practices to thrive while maintaining the integrity and transparency required for Medicaid billing. We propose the development of a pilot program—a beta test initiative—that would allow small private practices to demonstrate their ability to meet CORE provider requirements without the overwhelming financial and regulatory burden currently imposed.
Our request is simple: Trust us. We have the expertise, the credentials, and the passion to make this work. We are not asking for exceptions—we are asking for fairness. New York’s mental health system must evolve to accommodate the growing need for services, and that means ensuring that smaller, community-focused providers are not excluded from the process.
What Needs to Happen Next
We call on DCMH and other governing bodies to:
Reevaluate the barriers to CORE certification for private mental health practices.
Provide clear, actionable steps for smaller providers to meet Medicaid billing requirements without risking financial collapse.
Ensure that alternative funding sources are legitimate before pushing providers away from CORE designation.
Engage in meaningful dialogue with providers like Mindful Living to develop a sustainable and inclusive framework for mental health services.
The mental health crisis in New York demands action, and that action must include all willing and qualified providers. Mindful Living LCSW PLLC stands ready to contribute. Now, we need the government to meet us halfway. We also believe that effective and sustainable peer support services should not be limited to large agencies with disproportionate access to financial and regulatory resources. The Mindful Living Allowable designation is our solution—a structured yet flexible framework that allows private mental health practices to offer Medicaid-reimbursed peer support services in a way that is financially viable and operationally feasible.
Why This Plan Matters
- Expanding Access to Services: Many individuals in need of peer support services cannot access care due to limited provider options. By integrating private practices into the CORE provider framework, we create new pathways for clients to receive support from experienced, credentialed professionals.
- Bridging Regulatory Gaps: The existing Medicaid billing process creates undue burdens on small providers. The Mindful Living Allowable provides a pilot-tested model that ensures compliance without forcing unsustainable operational costs onto private practitioners.
- Ensuring Sustainability: Large agencies receive disproportionate funding, leaving small providers at a disadvantage. By implementing a provisional certification system, we enable private providers to function within Medicaid without the financial pitfalls that often hinder small-scale operations.
- Building a Transparent and Accountable System: We recognize the necessity of structured oversight and regular evaluations to ensure that services provided under this designation meet Medicaid standards. By partnering with DCMH, we aim to set clear benchmarks for quality care and financial sustainability while creating an inclusive, scalable model for mental health service delivery.
How Westchester Can Lead the Way
Westchester County has an opportunity to be at the forefront of innovative mental health service integration. By supporting this initiative, local leadership can:
- Establish a first-of-its-kind private practice peer service framework that can be replicated statewide.
- Reduce pressure on overburdened large agencies while increasing service accessibility for clients in need.
- Set a precedent for collaborative mental health governance that fosters public-private partnerships to address mental health care challenges.
Moving Forward
We call upon stakeholders, policymakers, and community leaders to recognize the potential impact of this model. We are not just asking for permission—we are offering a solution that aligns with New York State’s broader goals for mental health equity and access.
This is more than just an initiative—it is a movement towards sustainable, community-driven mental health solutions. We welcome discussions, collaborations, and advocacy efforts to make the Mindful Living Allowable a reality.
1 thought on “The Barriers to CORE Certification: A Call for Change in Mental Health Service”
OMH is still insisting that all potential peer support providers conduct services for clients in-person (that is what they mean by “mobile”, to be clear). Unfortunately, this insistence is alienating a segment of the population of peers who, for multiple reason, either limiting their outside engagement due to lingering COVID pandemic fears, other types of fears, temporarily or permanently unable to get around independently due to acute or chronic physical conditions. One of the silver linings that grew out of the coronavirus pandemic is the sharp increase in the use of telehealth and virtual technologies for meetings, groups, and the receiving of services. How OMH can just dismiss this trend and bring everyone back to in-person services? The fight only just begun! Mindful Living is fully committed to expand upon its peer support pilot program and being able to bill Medicaid for peer support services.