Nov. 18—SANTA FE — After some families waited more than a decade, Gov. Michelle Lujan Grisham’s administration used federal pandemic funds to eliminate a long waiting list for a program that provides supportive services to individuals with developmental disabilities.
But the rapid change has strained the state’s supplier system and raised questions about cost containment, a new legislative report shows.
Specifically, about half of current providers are not accepting new clients in the developmental disability waiver program, which now serves about 7,900 New Mexicans, according to the Legislative Finance Committee report unveiled Monday.
Additionally, the total cost of the program hit in the most recent budget year was $773 million – federal funds make up the largest portion of that amount – as costs per customer continued to exceed projections.
That amount is expected to continue to grow in coming years, as the Lujan Grisham administration’s move to eliminate the waitlist is expected to cost about $40 million in additional state funds per year, plus federal matching dollars, starting in fiscal year 2025 .
Health Care Authority Deputy Secretary Kyra Ochoa said the agency is open to exploring incentives and performance-based bonuses for health care providers, but said implementing cost caps is difficult because of the 2022 settlement of a landmark lawsuit.
She also raised concerns about a legislative plan for a wage split that would require providers to send 80% of Medicaid reimbursement dollars directly to counselors, therapists and other professionals.
But Jim Jackson, the chairman of the state Disability Coalition, said additional investments will be needed to accommodate the increased number of program participants.
“To solve the capacity problem, you’re going to have to spend more money,” Jackson told the Journal after Monday’s hearing.
New Mexico’s developmental disability waiver program allows participants to receive therapy, employment assistance and other services aimed at becoming active members of the community.
According to LFC data, more than half of program participants live in the Albuquerque metro area and most are between the ages of 20 and 40.
The state launched welfare checks on all program participants in 2023, following the death of a 38-year-old female participant. The woman’s two caregivers were charged with abuse and neglect in connection with her death, along with other charges.
The Lujan Grisham administration has also hired an outside firm to make recommendations on how to improve the program. At least some of these recommendations have been implemented, including a reorganization of the state’s Developmental Disabilities Division, the LFC report shows.
According to the report, scheduled wellness checks are now also now conducted twice a year on all clients participating in the program.
However, Sen. Nancy Rodriguez, D-Santa Fe, questioned why some families previously on the program’s waiting list ultimately did not participate in the program when the state scaled it back.
“I want to make sure we don’t let people fall through the cracks who should be getting services,” Rodriguez said.
In response, state officials said some families on the waitlist ultimately declined state-provided services. It is possible that at least some other individuals have died or moved to another state.
