HOUSE MEMORIAL 16

48th legislature - STATE OF NEW MEXICO - second session, 2008

INTRODUCED BY

Jim R. Trujillo

A MEMORIAL

URGING THE DELAY OF IMPLEMENTATION OF CHANGES IN COORDINATED LONG-TERM SERVICES.

     WHEREAS, the human services department and the aging and long-term services department have planned to implement a new program of managed care for individuals receiving long-term services, known as coordinated long-term services, beginning on July 1, 2008; and

     WHEREAS, persons receiving services provided in the disabled and elderly waiver, the personal care option or nursing facilities would be required to receive all medical and long-term medicaid services through coordinated long-term services; and

     WHEREAS, the number of "slots" for community-based waiver services in coordinated long-term services will be lower than the number currently established for the disabled and elderly waiver program, despite the great demand for these services; and

     WHEREAS, access to community-based long-term services will not increase in coordinated long-term services because waiver slots will continue to be limited; and

     WHEREAS, current rules on income eligibility favor institutional placement, and so access to personal care option services will still be available only to those with the lowest income; and

WHEREAS, implementation of coordinated long-term services will not reduce the waiting list for disabled and elderly waiver services, which waiting list includes over eight thousand persons and continues to grow; and

WHEREAS, time spent waiting for services is getting longer, and, as a result, people will be forced to enter nursing facilities or to go without critical services; and

WHEREAS, the Money Follows the Person in New Mexico Act, which allows a person who receives medicaid-funded services in a nursing home to use those funds to pay for community services in a waiver slot, was passed unanimously by both chambers of the legislature and was signed into law in March 2006; and

WHEREAS, the Money Follows the Person in New Mexico Act should allow more people to receive community services without increasing medicaid expenditures; and

WHEREAS, the proposed reduced limits on authorized waiver slots in coordinated long-term services would make full implementation of the Money Follows the Person in New Mexico Act impossible; and

WHEREAS, the rate structure for monthly payments to the coordinated long-term services managed care organizations for each individual enrolled is critical to determining whether an adequate level of services will be provided to participants; and

WHEREAS, a question remains as to whether there will be incentives to serve seniors and persons with disabilities in the community rather than in institutions, but the state has not yet provided the legislature or other stakeholders with information about the rate structure; and

WHEREAS, the state should be very cautious in moving toward managed care for long-term services, given the state's previous experience with managed care for physical and behavioral health; and

WHEREAS, development of the coordinated long-term services program has been undertaken by the human services department and the aging and long-term services department with minimal involvement by the legislature; and

WHEREAS, advocates for seniors and persons with disabilities have expressed serious and legitimate concerns over whether the program, as designed, will achieve its stated goal of improving accessibility to long-term services in the community rather than in institutions;

NOW, THEREFORE, BE IT RESOLVED BY THE HOUSE OF REPRESENTATIVES OF THE STATE OF NEW MEXICO that the human services department and the aging and long-term services department be requested to delay implementation of coordinated long-term services until July 1, 2009, at the earliest; and

BE IT FURTHER RESOLVED that the two departments consult in a meaningful way with representatives of providers and consumers on the design of the coordinated long-term services program; and

BE IT FURTHER RESOLVED that upon implementation of a coordinated long-term services program, the departments report regularly to the interim legislative finance committee and legislative health and human services committee on progress in developing the coordinated long-term services program; rates being paid for providers and enrollment; the cost per client; administrative costs; current rate structures; and the ways these provide incentives for community services instead of institutional care; and

BE IT FURTHER RESOLVED that the departments also regularly report on the numbers of clients in home- and community-based waiver services, persons receiving personal care option services and the numbers of persons in nursing homes; and

BE IT FURTHER RESOLVED that copies of this memorial be transmitted to the chairs of the interim legislative finance and health and human services committees and to the secretaries of human services and aging and long-term services.

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