NM Legislature Report

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This message is from Ellen Pinnes and The Disability Coalition.

Jim Jackson's post-session legislative report. The report summarizes the legislation of interest to the disability community that passed, as well as those measures that did not. Memorials are final once passed by the legislature and don't require action by the governor. Bills can be signed or vetoed -- the governor has until March 5 to act.

DISABILITY ISSUES IN THE 2008 LEGISLATURE

END-OF-SESSION REPORT

By Jim Jackson, Executive Director

PROTECTION AND ADVOCACY SYSTEM

February 18, 2008

Legislators Have Gone Home …. For Now. The 2008 legislative session came to a close last Thursday, having finished its principal work of adopting a state budget but leaving aside many of the other items that consumed so many hours of debate and discussion. The governor’s health care proposal, for instance, was substantially changed as it moved through committees and was ultimately tabled along with a competing health care authority proposal as well as a “single payer” approach. Domestic partnerships, transition to electronic medical records, and political ethics reforms, all sought by the governor, were left undone. So was a proposal to overhaul the funding formula used to allocate money to the public schools. Governor Richardson has already stated that he will call the legislature back into special session to deal with health care, but it is far from clear that this will produce the results he wants.


Good Results. This was a pretty good session for persons with disabilities. Legislators addressed the waiting lists for Medicaid waiver programs by adding $4 million to the DD waiver program and $750,000 to the D&E waiver. They added $1 million for the FIT early intervention program, provided start-up operational funding for the Native American Independent Living program, and added over $90 million in new funding to the basic Medicaid program. They insisted on greater accountability in the managed behavioral health program (Value Options), and called on the state to respond to the disability community’s concerns over plans to move many long-term service programs into a managed care environment.

The state budget has already been signed by the governor, with certain line-item vetoes, but some of the other bills passed are still awaiting action by the governor, who can either sign or veto them. Memorials passed by the legislature are complete and do not require action by the governor.

Here’s a brief review of disability-related legislation that passed in this session, a final accounting of additions to disability programs in the state budget, and a list of the substantive bills and memorials that didn’t pass.

BILLS AND MEMORIALS THAT PASSED IN 2008
H 181 Behavioral Health Collaborative Reforms. Rep. Lucky Varela. This bill requires the state purchasing collaborative to 1) submit a combined behavioral health budget that identifies the part of each participating agency’s budget that flows through the collaborative for behavioral health services, 2) develop and issue regulations on quality standards and performance measures, and 3) provide regular performance reports to the legislature.

H 364 Children’s Mental Health/DD Code. Rep. Rick Miera. This bill makes a number of technical amendments to the Code, which was significantly revised last year. A few minor glitches in the language of the Code were identified and are corrected by this bill.

HM 4 Medicaid Recertification Pilot Project. Rep. Danice Picraux. This memorial calls on the Human Services Department to report data related to its current pilot project to simplify the Medicaid eligibility recertification project, and to refrain from “autoclosure” of cases.

HM 16 Address Concerns in Managed Long-term Services Program (“CLTS”). Rep. Jim Trujillo. The final version of this memorial, based on negotiations with ALTSD and HSD, describes the concerns of advocates and providers about the state’s plan to move most Medicaid long-term services into managed care, and asks the state to address these concerns prior to implementation of the program. The memorial also calls for meaningful consultation with advocates and providers, and for progress reports to interim legislative committees.

HM 34 Anti-depressant Task Force and Study. Rep. Tom Anderson. This memorial calls on the Health Policy Commission to convene a task force to study the possible correlation between certain anti-depressants and suicidal thoughts and behaviors.

S 145 Cap on Due Process Hearing Reimbursements. Sen. Cynthia Nava. This bill reduces the maximum insurance reimbursement a school district can receive to cover the costs of a due process hearing, to $100,000. If there is not enough funding from premiums paid by the schools to cover all reimbursement requests, payments can be reduced proportionally.

S 355 Raising Income Limits for Property Tax Freeze. Sen. John Ryan. This bill provides that homeowners who receive Social Security benefits on the basis of disability, or who are determined “totally disabled” under a Worker’s Compensation claim, are exempt from increases in property taxes on their home if their income does not exceed 235% of the federal poverty level. This is a significantly higher eligibility level for this benefit than in existing law.

SM 9 Anti-depressant Task Force and Study. Sen. Joe Carraro. Same as HM 34.

SM 10 Medicaid Recertification Pilot Project. Sen. Jerry Ortiz y Pino. Same as HM 4.

SM 17 Address Concerns in Managed Long-term Services Program (“CLTS”). Sen. Jerry Ortiz y Pino. Same as HM 16.

SJM 9. Monitor Pre-special-education Services. Sen. Cynthia Nava. This memorial calls upon the Public Education Department to monitor the implementation of the “response to intervention” approach by school districts and to evaluate the impact that this approach has on the academic progress of students and on the identification of students as needing special education and related services. This approach requires schools to use specific intervention methods for students with academic delays, and refer for special education assessment and services only if this intervention fails.

SJM 31 Behavioral Health caucus. Sen. Mary Kay Papen. Calls on the legislature itself to form a behavioral health caucus of Senators and Representatives interested in substance abuse and mental health, with the goal of increasing legislators’ knowledge regarding mental health issues and hopefully resulting in increased appropriations for mental health services.

THE FINAL STATE BUDGET
HB 2 General Appropriations Act. This is the bill that funds the main operating budget for all state agencies. The list below focuses on the changes to the state agency budgets that affect programs serving persons with disabilities.

Medicaid. There is over $92 million in additional state money (which will generate another $230 million in federal funding) for the Medicaid program, but this is about $10 million short of the amount requested by the governor and as much as $30 million less than what HSD now thinks may be needed in the coming year. However, there is considerable controversy over these budget projections, because HSD’s estimates are based on projected growth in enrollment that many legislators (and others) believe are too optimistic.
Developmental Disabilities. $4 million more to reduce the waiting list for DD waiver services, and $1 million for FIT early intervention services. Another $750,000 was added to the budget to provide rate increases for agencies providing services through state funds (not Medicaid), but this provision was vetoed by the governor.
Long-Term Services. $750,000 to reduce the waiting list for the D&E waiver program, plus funding to pay for 6 new employees at ALTSD to oversee the new managed long-term services program called CLTS (which is scheduled to begin July 1), and funding for 3 new staff positions to manage Mi Via, the self-directed waiver.
Brain Injury. $600,000 to HSD for outreach and services to veterans with behavioral health issues, including TBI or post-traumatic stress syndrome. HB 2 also includes language allowing any unspent FY 08 funds that were earmarked for persons with brain injuries in the Mi Via waiver to be transferred to the state TBI Trust Fund. A significant portion of the $1.9 million earmarked for TBI/Mi Via will not be spent this year because of slow and limited enrollment.
Mental Health. $500,000 for state-wide mental health services, and $350,000 for a mental health triage center in Dona Ana County.
Independent Living. 1) $105,000 for initial operational expenses of a Native American Independent Living program. 2) Authorization for a full-time position at GCD to provide an adaptive driver-training program. An additional $2,000 for this program was included in SB 165 (see below).
Miscellaneous. 1) $150,000 for additional legal services to low income New Mexicans. 2) $267,000 in additional funding for the DD Planning Council for guardianship services provided by its contractors. 3) Reimbursements to public schools for the cost of certain services provided to home-schooled special education students were funded with an appropriation of $160,000, but this funding was vetoed by the governor. 4) An appropriation of $100,000 to ALTSD for the purpose of studying and promoting the use of “microboards” as an alternative to guardianships was also vetoed.

SB 165 (“HB 2 Junior”). Supplemental Appropriations. This bill provided an opportunity for each legislator as well as Governor Richardson to spend a little money on their favorite programs or local or statewide needs. Several disability programs have received funding in this bill, which has been signed into law by the governor with some line-item vetoes. The bill includes:

$171,700 to NMSU for speech/language pathology and autism outreach services
$50,000 to GCD for community outreach for deaf persons.
$50,000 to the Roswell branch campus of Eastern New Mexico University for counseling and other services for students in the special services program
$40,000 to HSD for behavioral health and support services to Native Americans in northwestern New Mexico.
$30,000 to Santa Fe Community College for a sign language interpreting program
$25,000 for rehabilitation training at the Commission for the Blind
$25,000 to ALTSD for a brain injury clubhouse program
$25,000 to CYFD for a program in Dexter for children and young adults with autism spectrum disorder, including staff training.
$20,000 to DOH for telehealth psychiatry in the Carlsbad area
$20,000 to New Mexico State University to expand the communication disorders (S/LP) training program
$20,000 to DOH for a residential summer camp for children with autism
$20,000 to the General Services Department for a full-time employee to implement the State Use Act.
$20,000 to DFA to develop and implement an early childhood program for hearing-impaired children in Bernalillo County.
$15,000 to HSD for a clubhouse rehabilitation and socialization program for persons with mental illness
$15,000 to DOH for a horseback riding program for special needs children
$15,000 to DOH for Special Olympics in the city of Las Vegas.
$10,000 to the 13th judicial district for mental health court
$10,000 to the School for the Blind and Visually Impaired for the low-vision clinic.
$7,000 to PED for the Fiesta Educativa conference in the Gadsden area
$2,000 to ALTSD for a traumatic brain injury awareness program.
$2,000 to GCD for an adaptive driver’s training program for seniors and persons with disabilities.
$1,000 to DOH for autism spectrum disorder groups and/or diagnostic services
BILLS AND MEMORIALS THAT FAILED TO PASS
(Other than appropriation requests)

Medicaid
H 182 Medicaid application and retention. Rep. Lucky Varela. This bill would have directed HSD to simplify the Medicaid enrollment process, and prohibited HSD from using “autoclosure”, the process through which many Medicaid recipients are automatically dropped from Medicaid if they have not been re-certified by an HSD caseworker by the time their eligibility period ends, regardless of whether they have submitted information that has not yet been processed.

H 268 Medicaid cost-sharing. Rep. Keith Gardner. This bill would have established cost-sharing requirements for Medicaid recipients, including monthly premiums and co-pays for medications and emergency room visits.

Mental Health
HJM 27 Behavioral health legislative caucus. Rep. Ed Sandoval. Same as SJM 31, which did pass.

SJM 15 Crisis residential treatment services. Sen. Steven Komadina. This memorial asked HSD to study a plan to implement a system of response to and short-term treatment of persons suffering psychiatric crises who do not present a danger to themselves or others, and to report the results of the study by the end of the year.

Education/Higher Education

H 23 Definition of related services. Rep Bobby Gonzales. This bill would have added a definition of related services as used to determine special education funding allotments to public schools.

H 241 Public school funding formula changes. Rep. Mimi Stewart. This bill, based on the work of a task force over the past two years, would have made significant changes to the public school funding formula, including setting one fixed payment rate per student regardless of the level of disability, and determining special education funding based on exactly 16% of the overall student population regardless of actual enrollment numbers in special education. The bill also would have made changes to other existing special education law, particularly with respect to students served in residential treatment centers. The bill was amended to provide that implementation of the proposed new formula would not happen until new funding mechanisms are authorized that produce over $300 million per year.

H 414 Special Education in Residential Treatment Centers. Rep. Thomas Garcia. This bill attempted to clarify which school district is responsible for special education services when a child is placed in a residential treatment center.

Health Care Reform
H 62 Health Care Reform Package. Rep. John Heaton. This was the governor’s health care reform proposal, which would establish a health care authority whose members he would appoint, require New Mexico residents to show proof of insurance, assess businesses for part of the cost of insuring employees not covered by the business, require insurance companies to accept applicants without regard to pre-existing conditions (although a six-month waiting period and higher premiums would be allowed), and mandate those companies to spend at least 87.5% of their premium income on health care services. The individual insurance mandate and employer assessment were dropped from the bill as it passed through committees.

H 147 Health Care Authority. Rep. Danice Picraux. This alternate proposal also would have created a health care authority, but its members would be more independent. The authority would be charged with developing a health coverage plan, including financing mechanisms, by January 2009. This bill did not include some of the other features of the governor’s plan.

H 588 Access to Quality Universal Health Insurance. Rep. Moe Maestas. Same as S 377 (see below).

S 3 Health Security Act. Sen. Carlos Cisneros. This proposal, usually referred to as the “single payer” model, would also establish a public health care authority, but would further create a health care system accessible to all residents. Most New Mexicans would be put into a single “pool”, and the authority would determine health benefits to be covered, provider payment rates, etc. The state would be the single payer of bills for services provided, without going through health insurance companies.

S 225 Health Care Authority. Sen. Dede Feldman. Same as H 147.

S 377 Access to Quality Universal Health Insurance. Sen. Michael Sanchez. This alternative proposal would have required that all state residents above 400% of the poverty level have health insurance and that insurers cover everyone who seeks to purchase insurance, and would have prohibited exclusions for pre-existing conditions. Insurers would have to spend at least 90% of premium revenue on direct health care services. A premium assistance program would be developed for residents with income less than 400% FPL.

Miscellaneous
H382 Tax deduction for long-term care premiums. Rep. Gail Chasey. This bill would have allowed state tax payers to deduct from their taxable income the cost of premiums paid for long-term care insurance. This approach subsidizes middle and upper income individuals who can afford such policies and there is some debate as to whether this is the best use of public funds in addressing the increased need for long-term care services.

S 511 License plates for persons with disabilities. Sen. James Taylor. This bill would have authorized a one-time $100 fee for a disability license plate (allowing the car to be parked in handicap-accessible parking spaces). $80 of each fee would go to the Governor’s Commission on Disability to support their programs.

ABBREVIATIONS USED IN THIS REPORT

State Agencies:

ALTSD Aging and Long Term Services Department

CYFD Children, Youth and Families Department

DDPC Developmental Disabilities Planning Council

DFA Department of Finance and Administration

DOH Department of Health

GCD Governor’s Commission on Disability

HSD Human Services Department

PED Public Education Department