SENATE MEMORIAL 25

54th legislature - STATE OF NEW MEXICO - first session, 2019

INTRODUCED BY

Elizabeth “Liz” Stefanics

A MEMORIAL

REQUESTING THE UNIVERSITY OF NEW MEXICO CENTER FOR DEVELOPMENT AND DISABILITY TO CONVENE A TASK FORCE TO STUDY THE NECESSITY OF NEEDED AMENDMENTS TO THE MEDICALLY FRAGILE WAIVER PROGRAM TO MEET THE NEEDS OF MEDICALLY FRAGILE INDIVIDUALS IN NEW MEXICO.

     WHEREAS, the medically fragile waiver program is a home- and community-based medicaid waiver program authorized under Section 1915(C) of the federal Social Security Act; and

     WHEREAS, the center for development and disability is the university of New Mexico center for excellence in developmental disabilities education, research and service; and

     WHEREAS, the center is authorized by the federal Developmental Disabilities Assistance and Bill of Rights Act of 2000 to increase the capacity of states and communities to respond to the needs of individuals with developmental disabilities and their families; and

     WHEREAS, individuals receiving services under the medically fragile waiver program have a medically fragile condition, which is defined as a chronic physical condition that results in a prolonged dependence on medical care for which daily skilled nursing intervention is medically necessary; and

     WHEREAS, the university of New Mexico center for development and disability administers the medically fragile case management program, which provides case management and care coordination services to individuals who have been diagnosed with a medically fragile condition before reaching the age of twenty-two, and who have a developmental disability or who are at risk for developmental delay, and their families throughout the state; and

     WHEREAS, the medically fragile case management program uses a family-centered approach to care and creates collaborative partnerships to act as advocates and resource persons to support families in their decision to care for a child who is medically fragile at home; and

     WHEREAS, medicaid reimbursement rates for the medically fragile waiver program were last increased in 2006; and

     WHEREAS, the medically fragile family advisory board is an advocacy group of parents with a child who is, or was, medically fragile; and

     WHEREAS, the medically fragile family advisory board has consistently expressed the need for amendments to renewals of the medically fragile waiver program and has noted that the difficulty in providing appropriate services is at a crisis level; and

     WHEREAS, studies in other states have shown that case management and care coordination programs for medically fragile individuals result in significant cost savings when compared to care provided in institutional settings; and

     WHEREAS, if the medically fragile case management program were to be discontinued, the inability to manage care in the home would result in institutionalization in acute hospital settings for many clients; and

     WHEREAS, many individuals on the medically fragile waiver require environmental modifications in their homes; and

     WHEREAS, services that are provided by registered nurses and case managers are affected by the numbers of respite hours available to clients; and

     WHEREAS, many medically fragile waiver program clients may benefit from alternative therapies, including massage therapy and acupuncture, and these therapies are not included on the menu of benefits; and

     WHEREAS, in recent years, more medically fragile waiver program clients are living into adulthood, yet how to meet the needs of these clients into the future has not been adequately addressed;

     NOW, THEREFORE, BE IT RESOLVED BY THE SENATE OF THE STATE OF NEW MEXICO that the university of New Mexico center for development and disability be requested to convene a task force to study the necessity of amendments to the medically fragile waiver program to meet the needs of medically fragile individuals in New Mexico; and

     BE IT FURTHER RESOLVED that the requested study provide:

          A. a cost-effectiveness analysis that provides quantitative data on the cost savings generated by the program as compared to care that would be provided in institutional settings if the program were to be discontinued;

          B. an analysis of the problems or issues faced by the program’s nurse case managers, the range of activities they undertake to resolve those problems or issues and the time spent by nurse case managers providing those services to establish the role and value of care coordination;

          C. an assessment of potential benefits of making environmental modifications to the homes of medically fragile individuals and recommendations regarding how such modifications could be included in the medically fragile waiver program;

          D. an assessment of the barriers to increasing respite hours available to families of medically fragile clients and recommendations for how to address those barriers to provide additional respite hours to support medically fragile individuals;

          E. an assessment of current research on the efficacy of alternative therapies and recommendations for ways to make alternative therapies available if they are found to be of value; and

          F. an assessment of how the needs of clients who are over the age of twenty-one could be addressed; and

     BE IT FURTHER RESOLVED that the center for development and disability at the university of New Mexico be requested to include participants from the human services department, the department of health, the college of nursing at the university of New Mexico, the center for life at the university of New Mexico, disability rights New Mexico and centennial care managed care organizations; and

     BE IT FURTHER RESOLVED that the task force be requested to include participation from parents and other family members of medically fragile clients, self-advocates and other appropriate advocacy entities; and

     BE IT FURTHER RESOLVED that the findings and recommendations of the study be presented to the legislative health and human services committee by December 1, 2019; and

     BE IT FURTHER RESOLVED that copies of this memorial be transmitted to the executive director of the university of New Mexico center for development and disability, the secretary of human services, the secretary of health, the director of the medically fragile case management program, the chair of the medically fragile family advisory board, the director of the center for life, centennial care managed care organizations and the director of disability rights New Mexico.

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