Thank you for exposing the disturbing trend of nonprofit mental health clinic closures on Long Island ["Crisis in the clinics: As demand grows, mental health facilities dwindle on LI," News, April 12]. For mental health providers, this does not come as a surprise.

The state's grand plan is to consolidate services by reducing the number of clinics and restricting access to care to Medicaid recipients only, thereby cutting middle class children and families out of the equation. Consolidation is by design, and is what the state refers to as its "regional centers of excellence" plan.

Some of the ways that clinics stay afloat, beyond fundraising, are to restrict access to care to families with Medicaid insurance, which pays higher rates than commercial insurers; to spend shorter periods of billable time with clients to pack more revenue into a day; and to replace salaried mental health professionals with fee-for-service workers to avoid paying for benefits.

In other words, build a factory that maximizes revenue and minimizes quality care.

I do not feel encouraged by a system that restricts access to care to one population only and dilutes quality care to drive up revenue. This is not excellence, but mediocrity. Long Island children and families deserve better.

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Andrew Malekoff, Long Beach

Editor's note: The writer is executive director of the North Shore Child & Family Guidance Center in Roslyn Heights, a nonprofit children's mental health center.