Lujan Grisham puts forward plan to address disability waitlist
Advocates say governor’s proposal leaves many questions still unanswered
Thousands of New Mexicans with autism, seizure disorder, Down syndrome and other developmental disabilities — many of them children — have been waiting more than a decade to gain access to medical care and therapy services.
Gov. Michelle Lujan Grisham proposed a three-phase plan Tuesday that aims to eliminate a 5,000-person waiting list within six years.
“A waiting list of this size is completely unacceptable and indicative of a lack of care and attention by state leadership in recent years,” Lujan Grisham said in a news release. She added her administration will create “high-quality services” to eliminate the backlog of people who are attempting to access services provided through a developmental disabilities waiver, including Medicaid.
“I want it done now, but it will take time, and we are aggressively pursuing the remedy,” she said. But advocates said the proposal is short on details. Developmental disability waivers connect individuals with Medicaid, as well as therapy and caregiving services in the community as an alternative to institutionalized care. The state said in March it would create an additional Medicaid supports waiver to help bridge the gap in services children and adults are missing as they wait to access the developmental disability waiver.
In the first phase of the plan announced Tuesday, the state said it will hire staff to work with individuals who already have Medicaid but are still on the developmental disability waiver waitlist to see if they are able to better optimize existing benefits. It also will fund additional services for waitlisted individuals.
David Morgan, a spokesman for the Department of Health, could not say how many staff would be hired, how much additional funding would be provided or what services might be covered by additional funding.
Jodi McGinnis Porter, a spokeswoman for the Human Services Department, emphasized the proposal is only that, and details will be finalized through public comment periods, outreach to those affected and legislative approval.
The Legislature allocated $1.5 million to develop the new Medicaid support waiver, funding that kicked in at the beginning of the month. An additional $7.5 million was allocated to help 300 people with developmental disabilities get off the waitlist.
The administration said the second phase of the plan will be implementing the supports waiver by 2021.
Finally, in phase three, the state will develop a “tiered” system, that will provided “more appropriate” benefits based on an assessment of an individual’s needs, according to a news release from the state Human Services Department.
An expert in the struggles faced by families with disabilities said the plan leaves many questions unanswered, including whether additional funds would be provided for key issues such as copays, child support and therapy services.
“It’s encouraging,” said Gay Finlayson, education and outreach manager for the Center for Development and Disability at the University of New Mexico Health Sciences Center. But she added: “There is not a whole lot of information.”
Finlayson warned that the tiered benefits system outlined in phase three could be problematic. While she said she supports individuals gaining access to appropriate benefits, that phase of the plan indicated some could lose access to certain services.
“It insinuates to me that there are people getting too many services,” she said, “And it is not true for anybody I know.”
Morgan said, in the final phase, individuals’ needs will be evaluated through a “validated assessment instrument,” though he did not specify what that might be.