Legislation designed to get the ball rolling on a state-sanctioned, but mostly federally-funded, behavioral health Medicaid waiver program for those at risk of institutionalization and jail appears to be in jeopardy.
Supporters of House Bill 70 want to establish the behavioral health waiver in a similar fashion as the current developmental disability waiver, which has been in place for decades and has thousands of enrollees. They say the waiver is an essential and long overdue step for thousands of New Mexicans who don’t qualify for the developmental disability waiver because their IQs are above 70, but still have severe behavioral health issues.
“It is the fastest and most effective intervention for changing the revolving door of incapacitated people clogging emergency rooms, hospital beds and sometimes jail cells — then casting them out onto the streets without essential treatment only to repeat the process,” Albuquerque attorney Peter Cubra said this week.
Cubra was the force behind crafting the Behavioral Health Medicaid Waiver legislation and building support for it in Santa Fe. He’s represented and advocated for those with disabilities for 40 years.
HB 70 would direct $1.1 million to the New Mexico Health Care Authority (HCA) to submit a behavioral health waiver application to the federal Centers for Medicare & Medicaid Services for authorization to operate the program — one of the first steps in a yearslong process. In its fully realized form, the waiver would provide group or family home arrangements and 24/7 support and wraparound services for those with serious mental issues, substance use disorders and/or brain injuries.
While the bill has successfully made its way through House committees and is due for a vote on the House floor, Cubra said it doesn’t have the HCA’s support, which is key to its survival. Although Rep. Tara Lujan, D-Santa Fe, one of the bill’s sponsors, engineered a substitute bill with changes that tried to address some of the HCA’s concerns; the effort doesn’t appear to have been enough.
In a statement to City Desk ABQ on Tuesday, officials said the HCA does not support the bill.
“The intentions of the current bill are good, but it lacks actual feasibility, financial backing and a clear strategy for long-term implementation,” spokesperson Marina Piña said.
Piña said that the HCA does not oppose a $1 million appropriation in House Bill 2 that would fund a feasibility study for a proposed waiver program.
“I suspect that the Health Care Authority will continue to oppose the bill,” Cubra said. “They’re not sure they want to do it, and so they’ll probably continue to resist it.”
Meanwhile, the clock is ticking: The legislative session ends March 22.
“It is very concerning that we may run out of time because of the administration’s resistance,” Cubra said. “The bill’s in jeopardy at this time.”
Cubra said the resistance is primarily because the HCA perceives it doesn’t have enough staff to comply with federal Medicare and Medicaid requirements that would be necessary under the bill.
“So even though the bill was designed to enable [the HCA] to both contract for outside help and add additional staff, they still are hesitant to take on one more thing having to do with complying with Medicaid rules,” Cubra said. “I’m discouraged — I’m not conceding that we won’t get it done — but I think that now our chance is not great.”