LFC Budget Hearing December 10, 2019 Kathy Kunkel, Cabinet - - PowerPoint PPT Presentation

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LFC Budget Hearing December 10, 2019 Kathy Kunkel, Cabinet - - PowerPoint PPT Presentation

Oct 16, 2023 331 likes •608 views

LFC Budget Hearing December 10, 2019 Kathy Kunkel, Cabinet Secretary 1190 S. St. Francis Drive Santa Fe, NM 87505 Phone: 505-827-2613 Fax: 505-827-2530 nmhealth.org 2 1190 S. St. Francis Drive Santa Fe, NM 87505 Phone:

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LFC Budget Hearing

December 10, 2019 Kathy Kunkel, Cabinet Secretary

1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

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SLIDE 2

1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

Our Mission, Vision, & Values

Vision: A Healthier New Mexico Mis Missio ion: n: Promote health and wellness, improve health outcomes, and assure safety net services for all people in New Mexico. Valu lues: es: Accountability, Communication, Teamwork, Respect, Leadership, Customer Service

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

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NM Department of Health

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

Planning & Performance Monitoring Process

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

Department of Health

FY 21-23 Strategic Plan

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NM NMDO DOH’s goal al for FY21 is is to fac acil ilitate an an int integrated st strategic pl plan anning pr process in in order to be better:

  • Embed our mission, vision, values and priorities

inside our organization at every level

  • Use Performance Management to institute a results-

based organization

  • Strengthen and expand best practices through

reaccreditation

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SLIDE 7

1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

Department of Health

FY21-23 Strategic Plan Goals

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  • Exp

Expand and A Access t to S Servic vices

  • Improve He

Heal alth S th Statu tatus

  • Ens

Ensure S Saf afe Heal alth thcar are En Envir vironment nt Stat tatewid ide

  • Pu

Pursue O Org rganiz anizat ational nal Ex Excellenc nce

FY FY20: 4 : 44 AGA Per erformance M Meas easur ures FY FY21: : 76 A AGA P Per erformance Meas easur ures

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SLIDE 8

1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

Department of Health

FY21 Budget Overview

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FY21 1 Appr ppropri priat ation ion Request t (thousands) ) Revenu nue General Fund 327,680.4 Other Transfers 36,457.2 Federal Funds 102,798.4 Other State Funds 122,661.1 Fund Balance 0.0 Tota tal 589,597.1

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SLIDE 9

1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

DOH Budget Request Approach

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Request a adequat ate f e fund nding ing for

  • r cr

crit itical ical statewid ide p prior iorit itie ies 1. Elim imin inate t e the 1 13.5 .5 year ar DD DD Waiv iver er Wait iting ing lis ist 2. Impa pact popu populat ation he heal alth by: a) Reducing transmission of infectious diseases via increased vaccination rates and syringe services b) Addressing substance use disorder 3. Provid ide o

  • versig

ight an and d qualit ity of y of ca care in in New M Mexico xico’s ’s boar ardin ing hom

  • mes, h

hos

  • spit

itals, cr , cris isis is triag iage ce cent nters, and , and

  • ther f

facil cilit itie ies 4. Im Improve s saf afety n net ser ervice ices f for

  • r the elderly, v

, veterans, and and others in in the DO DOH facil acilit ities ies an and d com commun unit ity pr prog

  • gra

rams

  • DDS

DSD

  • PHD/ERD
  • DHI
  • FACILITIES
  • SLD
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SLIDE 10

1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

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DD Waiver Trends Since FY2011

4, 4,01 011 4, 4,09 091 4, 4,02 029 3, 3,66 666 3, 3,52 525 3, 3,70 700 3, 3,90 904 4, 4,47 479 5, 5,06 064 2,000 2,500 3,000 3,500 4,000 4,500 5,000 5,500 FY11 FY12 FY 13 FY 14 FY 15 FY 16 FY 17 FY 18 FY 19

Wait ait L Lis ist DDS DDSD PHD/ERD DHI FACILITIES SLD

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SLIDE 11

1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

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Challenges in Reducing the Waitlist

  • 360 added to waitlist on average each year (yet only 6 attrition

allocations each month)

  • 25 expedited allocations this year
  • 4530 completed applications
  • 413 allocations on hold
  • 2639 under the age of 22
  • Longest wait in metro region (since 1/24/2007)

DDS DDSD PHD/ERD DHI FACILITIES SLD

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SLIDE 12

1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

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Solutions that will provide relief for waitlist applicants

  • Ensure all who are eligible receive Early Periodic Screening,

Diagnosis, and Treatment (EPSDT) and community benefit

  • Implement a short-term family supports and reimbursement

program

  • Develop a new supports waiver in FY21 to support 2,000

individuals in the first year

  • Request $1.4 million to conduct acuity assessments to reform

the DD Wavier system

  • Request an additional $7.5 million for the DD and Mi Via

Medicaid waivers

  • Clean up the waitlist

DDS DDSD PHD/ERD DHI FACILITIES SLD

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SLIDE 13

1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

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New Supports Waiver Details

  • Governor’s Initiative (April 2020 pending funding)
  • Created to bridge service gap from waitlist to

allocation for Traditional or Mi Via waivers

  • Traditional or Self-Directed options
  • Will serve an additional 2,000 individuals per year
  • $10K allocation limit per person
  • 10 services based on waitlist survey
  • Repurposes state general fund dollars to leverage

federal Medicaid revenue

DDS DDSD PHD/ERD DHI FACILITIES SLD

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

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Reforming Existing Waivers

TRADIT DITIO IONAL DD DD WAIV IVER ER

  • Adopt Standardized

Assessment Tool (for both waivers)

  • Review Outlier Budgets to

determine causation

  • Implement the Supports

Waiver MI I VIA IA W WAIV IVER ER

  • Review Outlier Budgets to determine

causation

  • Strengthen the Service Criteria to

Inform Third Party Administrator (TPA)

  • Increase oversight through Incident

Management Bureau (IMB) to detect ANE

  • Increase oversight through Quality

Management Bureau (QMB) for provision of services

  • Engaged with (NASDDS) National

Association of State Directors of Developmental Disabilities Services for technical assistance to improve

  • versight of the Mi Via waiver

DDS DDSD PHD/ERD DHI FACILITIES SLD

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

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  • Based on CMS Required Rate Study

performed by independent experts

  • Examines current “cost of doing business”

DD Waiver: 19% Underfunded Med Frag: 37% Underfunded Mi Via: 17% Underfunded

DD, MF, & MI VIA Rates

DDS DDSD PHD/ERD DHI FACILITIES SLD

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

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Ca Caseload d Gr Growth in in Famil ily Infan ant Toddle ler

  • FIT had an average annual growth of 5%.
  • FIT is moving from DDSD to ECECD in FY21
  • FIT is a statewide network of 34 public and private providers
  • FIT serves approximately 16,000 children and their families in

Fiscal Year 2019

  • FIT received a highest national rating from the US Office of

Special Education Programs (OSEP) based on a number of performance indicators.

DDS DDSD PHD/ERD DHI FACILITIES SLD

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

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Drug Overdose Death Rates

New Mexico, 1991-2018, and U.S., 1991-2016

7.9 26.6 3.7 21.7 10 20 30 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

Deaths per 100,000 Population

New Mexico United States

Rates have been age-adjusted to the standard U.S. 2000 population Source: NMDOH, Bureau of Vital Records and Health Statistics; CDC WONDER

DDS DDSD PHD/ERD DHI FACILITIES SLD

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

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Alcohol-Attributable Death Rates

New Mexico, 1990-2018, and U.S., 1990-2016

20 40 60 80 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 DEATHS PER 100,000 POPULATION New Mexico United States

Rates have been age-adjusted to the 2000 U.S. standard population Data Sources: NCHS (US); NMDOH BVRHS; UNM-GPS; IBEB SAES; CDC ARDI v. 2

DDS DDSD PHD/ERD DHI FACILITIES SLD

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

19 The The gra raph a above s sho hows tha hat t the he ra rates of

  • f neon
  • natal a

abstinence s syn yndrome ( (NAS) ha have b been incre reasing b both h in NM M and the he US. . The numb mber o

  • f bab

abie ies s diag diagnose sed wit with N NAS in S in NM has as mo more t than an q quadr adrupled in in the past past de decade

  • ade. N

NAS b S bab abie ies s repr prese sent b but a a su subse set o

  • f al

all bab abie ies b s born exp xpose sed to su subst stan ances. .

DDS DDSD PHD/ERD DHI FACILITIES SLD

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

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Improving Population Health

Requesting:

  • For public health nurses to work in the schools to increase

vac accinat ation c coverag rage, $200 thousand.

  • To improve t

toxicol

  • logy, processing, and staffing in the state lab

division, $1 million.

  • For the state’s 39 health councils to address local pu

publ blic health nee eeds, , $184.5 thousand.

  • For the trauma system fund to support the development of new

trauma ce cent nter ers s stat atewid ide, $400 thousand.

DDS DDSD PHD/ERD DHI FACILITIES SLD

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

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Substance Use Disorders

Request for critical services:

  • Incre

ncreas ase Syri ringe s service vices - $400,000

  • Expand

and Medicat cation ion Assis isted d Treatm tment nt (MAT) in Public Health regions - $450,000

  • Neonat

atal al Abstin tinence ce Syndr ndrom

  • me Preventi

tion

  • n - $200,000
  • Create “Office

ice of Alcohol a and nd Popu pulati ation

  • n Heal

alth th” in Epidemiology and Response Division - $180,000

DDS DDSD PHD/ERD DHI FACILITIES SLD

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

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Left: The number of clients participating in syringe services is growing steadily.

DDS DDSD PHD/ERD DHI FACILITIES SLD

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

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Health Certification, Licensing, and Oversight

Requesting $1.3 million for investigations of abuse, neglect, and exploitation needed to improve and implement oversight of:

  • Boar

Boarding ing Ho Homes

  • Cris

risis is triag triage c cent nters

  • Assis

isted l living iving fac acil ilitie ities (2 (237 l lic icens nsed)

DDS DDSD PHD/ERD DHI FACILITIES SLD

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

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Assure Safety Net Services for All

Facilities Revenue Plan

Wor

  • rk w

wit ith partne ners to

  • leverag

age p pat atie ient b bil illin ing:

  • Seeking accreditation for Turquoise Lodge Hospital
  • Expanding billable services such as Medication

Assisted Treatment,

  • Improving DOH billing capacity, and
  • Contracting for a new Electronic Health Record

DDS DDSD PHD/ERD DHI FACILITIES SLD

Turquoise Lodge Hospital

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

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Assure Safety Net Services for All

Facilities Revenue Plan

Develo elop lo long-term econ conomic feasibility pl plan and nd de determine:

  • Whether local populations are sufficient to sustain facility
  • Whether we can improve our use of best practices
  • What safety net services are not offered that could be
  • What services do we currently offer that are not safety net
  • Whether we are leveraging all available revenue streams
  • Inform
  • rm future

re mas aster r plann annin ing acti tivi vitie ies

DDS DDSD PHD/ERD DHI FACILITIES SLD

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

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Scientific Laboratory Overview

  • Provides laboratory testing for State and local agencies in infectious

diseases, environmental hazards and impaired driving

  • More than 125,000 tests per year
  • Consultant services for partner agencies as well as healthcare community
  • Expert testimony in courts for impaired driving.
  • Run intoxilyzer breath alcohol program for state law enforcement agencies
  • State Lab is currently experiencing a budget shortfall

DDS DDSD PHD/ERD DHI FACILITIES SLD

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SLIDE 27

Thank you

Kathy Kunkel, Cabinet Secretary New Mexico Department of Health

1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org