A waiting list to join a program for developmentally disabled New Mexicans may be gone, but challenges remain

Nov. 18—SANTA FE — After some families spent more than a decade waiting, Gov. Michelle Lujan Grisham's administration used federal pandemic funds to eliminate a lengthy waitlist for a program providing support services for individuals with developmental disabilities.

But the rapid change has strained the state's provider system and led to cost containment questions, a new legislative report found.

Specifically, about half of the 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.

In addition, the total cost of the program hit hit $773 million in the most recent budget year — federal funds make up the bulk of that amount — as per-client costs have continued to surpass projections.

That amount is projected to keep growing in future years as the Lujan Grisham administration's move to eliminate the waiting list is projected to cost about $40 million in additional state funds annually, plus federal matching dollars, starting in the 2025 budget year.

Health Care Authority Deputy Secretary Kyra Ochoa said the agency is open to exploring incentives and performance-based bonuses for providers, but said implementing cost caps is difficult due to the 2022 settlement of a landmark lawsuit.

She also expressed wariness over a legislative plan for a wage pass-through that would require providers to funnel 80% of Medicaid reimbursement rate dollars directly to counselors, therapists and other professionals.

But Jim Jackson, the chairman of the state's Disability Coalition, said additional investments will have to be made in order 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 legislative hearing.

New Mexico's developmental disabilities waiver program allows participants to receive therapy, help with employment and other services aimed at allowing them to be active members of the community.

More than half of the program's participants live in the Albuquerque metro area and most are between 20 to 40 years old, according to LFC data.

The state launched wellness checks of all program participants in 2023, after the death of a 38-year old female enrollee. The woman's two caretakers were charged with abuse and neglect, along with other charges, in connection with her death.

The Lujan Grisham administration also hired an outside firm to make recommendations on how to improve the program. At least some of those recommendations have been implemented, including a reorganization of the state's Developmental Disabilities Support Division, the LFC report found.

Scheduled wellness checks on all clients enrolled in the program are also now conducted twice per year, according to the report.

However, Sen. Nancy Rodriguez, D-Santa Fe, questioned why some families previously on the program's waiting list did not end up joining the program when the state pared it down.

"I want to make sure we're not letting people fall through the cracks who should be getting services," Rodriguez said.

In response, state officials said some families on the waiting list ultimately declined state-provided services. At least some other individuals may have died or moved to another state.