NEW MEXICO
The extensive waiting lists for home and community-based services in New Mexico have caused legislators to propose the creation of task forces to consider expanded community options for people with disabilities.
Home and Community-Based Services
A lawsuit (Lewis vs. New Mexico Department of Health) filed in January 1999 by the state's protection and advocacy agency is in federal court. It was filed on behalf of 3,000 individuals with developmental disabilities in nursing facilities or in ICF/MR facilities who are on Medicaid waiver waiting lists for community services or who would benefit from waiver services. In 2002, the state's home and community-based services (HCBS) waiver program for people with developmental disabilities had an approved cap of 3,200, was serving about 2,300 people, and had a waiting list of about 2,600 individuals. The HCBS waiver program for the elderly and disabled had a cap of 1,950 people, was serving 1,500, and had a waiting list of about 2,500.
Planning and Reports
The Legislature approved several measures in 2002 that requested studies of various aspects of the state's long-term care system. One measure requested the Governor's Committee on Concerns of the Handicapped to lead a task force to develop a comprehensive and coordinated state plan in response to the Olmstead decision. The Human Services Department and the Health Department were to participate in the task force and were to report to the Legislature on an assessment of people currently in institutional settings in the state and their ability to live in the community instead.
The Legislature also created a Medicaid Reform Committee in 2002 that was charged with reviewing the program's services, delivery, funding and policy. Composed of 12 legislators and 18 public advisory members, the committee held 21 full-day meetings during the year. The committee considered almost 100 short- and long-term cost-cutting strategies, and delivered its report in December 2002.
In regard to long-term care services, the committee said that reconfiguring the long-term care delivery system includes emphasizing home and community-based services that are " ... generally more favorable to the patient and less costly than institutional care." The committee recommended that a cost-benefit analysis be conducted of the Medicaid personal care option with an evaluation of consumer-directed versus consumer-delegated care. Another committee recommendation called for expansion of the PACE program to an urban area beyond the current Albuquerque model and consolidation into one cabinet-level agency of all the long-term care services provided by the Department of Health; Children, Youth and Families Department; Human Services Department; and the State Agency on Aging.
Legislators also requested a study by the Long-Term Care Regulatory Quality Cabinet of acuity-based staffing in nursing homes.
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