Ledes from the Land of Enchantment

NM needs to expand its long-term care insurance

I’ve spent my life with people with intellectual disabilities.

My uncle was born in Arkansas in 1917. At 9 months of age he developed a fever, the cause of which was never diagnosed. The fever left him with considerable mental retardation. In 1917 there were no services for people with intellectual disabilities. So my grandmother became his direct supporter. They were together every day of their lives for 62 years. When my grandmother was sick and in the hospital, my uncle would lie next to her in bed. When my uncle was sick and in the hospital, my grandmother would lie next to him in bed. My grandmother died in 1979. My uncle died three months later because the only caregiver he had ever known was no longer in his life. This is the dramatic impact these dedicated caregivers have on the lives of the people they care for.

The Association of Developmental Disabilities Community Providers (ADDCP) is a nationwide membership organization. ADDCP supports members from Carlsbad to Farmington and Las Cruces to Taos. All of these agencies provide some form of service and assistance to New Mexico citizens with intellectual and developmental disabilities. Our mission statement is: “To promote and advocate quality, community-based services for children and adults with intellectual and developmental disabilities in New Mexico.” The central component of this statement is the direct support staff who provide these services.

Adrienne Smith, President and CEO of the New Mexico Caregivers Coalition, correctly outlined the current plight of direct carers in her November 1 comment “The Executive’s Desk” in the ‘s Business Outlook. ADDCP member agencies report that they cannot fill vacancies for direct support in their agencies. The COVID pandemic made the situation worse. Nevertheless, we have a crisis to find capable and competent workers.

The job of a direct support professional in today’s marketplace is quite demanding. The training requirements are clearly defined and strict. Regardless of the myriad reasons for not choosing this career field, the intricacies of funding these very important services must also be understood.

Developmental disability benefits are reimbursed based on a fee for the service. The reimbursement rate for services is based on cost studies typically commissioned by the New Mexico Department of Health. The latest cost study was carried out in fiscal year 2018 and completed in fiscal year 2019. It was based in part on fiscal 2017 expense reports provided by ADDCP member agencies and other vendors. This cost study fully financed only 19 of the 34 individual service tariffs. The remaining 15 tariffs will hopefully be financed from July 1, 2022. The financing of these tariff reimbursements is included in the budget application from the Ministry of Health for the budget year 2023.

ADDCP helps raise wages for direct support professionals as well as anyone else who works in the field. Providers cannot raise wages if the reimbursement rate for the services provided is three to four years behind the cost of providing those services. Over the next two years, 4,100 people are expected to be employed. This may remove the waiting list for services ( Editorial Nov. 2).

Without significant allocations to the Ministry of Health, there will be no providers to service these new allocations or to continue to serve current beneficiaries. Sixteen service providers have discontinued various services since the 2021 financial year. A solution to this crisis will not be easy. It’s going to be expensive. Given the forecast that New Mexico will fill 75,000 new home nursing and direct care jobs by 2026, the question to be answered in relation to this crisis is “If not now, when” do we start looking around to take care of our direct caregivers?

Jim Copeland has spent his life in professional, personal and family services for the intellectual disability. His brother-in-law died in 2008 while taking care of the developmental waiver in New Mexico.

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