Finding mental health care can be overwhelming, especially with insurance barriers, difficulty finding providers, and confusing regulations. That’s where the Community Health Access to Addiction and Mental Healthcare Project (CHAMP) steps in.
CHAMP is the New York State Behavioral Health Ombudsman Program dedicated to helping individuals, families, friends, and providers navigate mental health and substance use disorder services. Whether it is finding insurance, understanding summary benefits, locating providers who accept their insurance, or learning about appeal rights, or assisting with writing and submitting appeals, CHAMP helps consumers overcome barriers to accessing treatment. CHAMP will also help with understanding protections under New York State law, guiding them step-by-step through the process as advocates. In addition to advocacy, CHAMP serves as an informational resource for New Yorkers seeking care.
According to CHAMP, the number one challenge people face when trying to obtain mental health treatment is simply finding a provider who is available, accessible, and accepts their insurance. “A lot of providers don’t work with insurance,” Ryan, CHAMP’s NYS Behavioral Health Ombudsman Program Director noted. Transportation can also become an issue in upstate New York. New York laws give consumers added protections for state-regulated insurance plans. CHAMP helps people understand and use those protections. Advocates also help consumers identify providers within their network and navigate situations where access to in-network care is limited.
“CHAMP's structure is kind of a hub and spokesmodel,” said Ryan. CHAMP’s main helpline is run by the Community Service Society, and also has a network of community-based and specialist organizations throughout the state. Specialist organizations provide expertise in different areas of the law, insurance process, or provider networks. Community-based organizations are spread across the state and provide direct access to care. “They are familiar with the resources on the ground, which organizations have space available, and who to contact. It provides a level of insight and access that is extremely valuable,” explains Ryan.
Learn more about New York’s Network Adequacy Regulations through CHAMP’s resources. These new rules help people find providers within their insurance network and, when in-network options are not reasonably available, obtain out-of-network care at no additional cost. For consumers who experience challenges navigating the process or accessing care, CHAMP is available to provide guidance and advocacy to help ensure the regulations are being properly implemented and that people receive the coverage and care they deserve.
How to get help
For people looking for answers or support, CHAMP recommends starting with its website, which offers educational resources, appeals/complaints process, or a provider network.
For more specific concerns, people can call CHAMP’s helpline at 888-614-5400 and press 2 to speak directly with an advocate. Advocates can begin assisting callers the same day by evaluating their situation, helping determine next steps, and connecting them with local organizations within the CHAMP network that can provide additional support and guidance.