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F I S C A L I M P A C T R E P O R T

SPONSOR Lopez

ORIGINAL DATE

LAST UPDATED

02/20/07

03/02/07 HB

SHORT TITLE Developmental Disabilities Unfunded Mandates

SM 15/aSRC

ANALYST Hanika Ortiz

ESTIMATED ADDITIONAL OPERATING BUDGET IMPACT (dollars in thousands)

FY07

FY08

FY09 3 Year

Total Cost

Recurring

or Non-Rec

Fund

Affected

Total

$.1

see narrative

(Parenthesis ( ) Indicate Expenditure Decreases)

SOURCES OF INFORMATION

LFC Files

Responses Received From

Department of Health (DOH)

Human Services Department (HSD)

SUMMARY

Synopsis of SRC Amendment

The Senate Rules Committee Amendment invites members from the Developmental Disabilities

Planning Council, the ARC of New Mexico, the Protection and Advocacy System and other

interested individuals or organizations to participate in the Task Force.

Synopsis of Original Bill

Senate Memorial 15 requests the DOH form a task force to identify unfunded mandates in the

developmental delay and disability service systems and solutions identified to ensure the

financial viability of the system so quality services and supports can be reasonably maintained.

Serving on the task force will be the Developmental Disabilities Supports Division (DDSD) and

the Division of Health Improvement (DHI) from the DOH, the Medical Assistance Division of

the HSD and the Association of Developmental Disabilities Community Providers. The task

force will be required to report its findings and recommendations to the Legislative Health and

Human Services Committee and the Legislative Finance Committee no later than October 1,

2007.

Senate Memorial 15/ aSRC – Page

2

FISCAL IMPLICATIONS

This study may help address provider and community concerns that providers have lost qualified

staff or have had to reduce or eliminate benefits to employees due to inadequate reimbursement;

and, an increase in uncompensated regulatory demands within an overburdened service delivery

system. As with any study, there will be additional expenses to the Departments for the

allocation of staff and resources to support the tasks as defined in the memorial.

According to DOH/DDSD, the situation as defined in the memorial is attributed to increased

costs for insurance or higher operating costs linked to the price of fuel and other business related

commodities. The Departments report that the link between service requirements and loss of

agency staff is not clear. During the recent renewal of the Developmental Disabilities waiver

rates were adjusted in specific areas linked to increased expectations.

SIGNIFICANT ISSUES

The memorial has the following comments:

•

The department of health administers a variety of services and supports for children with

developmental delays and children and adults with developmental disabilities.

•

Developmental delay and disability services and supports are provided to eligible

individuals through contracts and provider agreements managed by the developmental

disabilities supports division of the department of health or the medical assistance

division of the human services department.

•

Developmental delay and disability services are funded through a variety of state and

federal sources such as state general funds and Medicaid programs, including early

periodic screening diagnosis and treatment, home and community-based waiver and

intermediate care facilities for the mentally retarded.

•

The developmental delay and disability service systems have become more complex

through the years due to increased expectations and demands and threatened or actual

litigation such as the Jackson lawsuit.

•

The volume of state-mandated policies, procedures and regulations has increased

dramatically resulting in unfunded mandates and an overburdened service system.

•

The uncompensated costs associated with compliance of unfunded mandates have

negatively affected the financial viability of the community-based provider system and

have led to decreases in direct care supports and services to children and adults.

•

Due to inadequate reimbursement and the need to comply with numerous unfunded

mandates, some providers have been forced to reduce or eliminate benefits to employees,

leading dedicated and well-trained staff to leave and seek other employment.

PERFORMANCE IMPLICATIONS

The DOH Statewide Adult Services Task Force, now renamed the Advisory Council on Quality

Supports to Individuals with Developmental Disabilities and Their Families (ACQ), is a

mechanism established under the New Mexico Developmental Disabilities Act of 1993 (Section

28-16A-13 NMSA 1978) to advise and assist DOH in the management of the developmental

disabilities service system. The ACQ has a standing Policy Committee, and Adult Services

Committee, a Children/Family Supports Committee and a Quality Committee which meet

Senate Memorial 15/ aSRC – Page

3

regularly. These committees may also meet jointly to consider issues which impact both policy

and service delivery. The ACQ is currently tasked with reviewing and providing

recommendations to DOH/DDSD on program policies, procedures and quality initiatives. The

ACQ membership includes recipients of the program services and their families, case manager

providers, direct care providers, advocacy groups and organizations, and State agencies including

HSD. ADDCP is a voting member of the ACQ.

ADMINISTRATIVE IMPLICATIONS

DOH and HSD may need to redirect staff from other activities for participation on the task force.

TECHNICAL ISSUES

Involvement of only ADDCP in the SM 15 task force may narrow the focus of the memorial to

the perspective of ADDCP members. There are others impacted by the program requirements

that are not represented in the SM 15 including case managers, other direct care providers,

program participants and their families, and advocates that could bring important input to the

identification and resolution of the issues specified in SM 15.

ALTERNATIVES

SM 15 could use the ACQ, an existing mechanism, to discuss issues related to service rules and

requirements.

WHAT WILL BE THE CONSEQUENCES OF NOT ENACTING THIS BILL

A task force to identify unfunded mandates in the developmental delay and disability service

systems will not be created.

AHO/nt