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

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: 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 3 1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

NM Department of Health 4 1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

Planning & Performance Monitoring Process 5 1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

6 Department of Health FY 21-23 Strategic Plan NM NMDO DOH’s goal al for FY21 is is to fac acil ilitate an an int integrated strategic pl st 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 1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

7 Department of Health FY21-23 Strategic Plan Goals • 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 FY20: 4 FY : 44 AGA Per erformance M Meas easur ures FY FY21: : 76 A AGA P Per erformance Meas easur ures 1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

Department of Health 8 FY21 Budget Overview 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 1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

9 DOH Budget Request Approach Request a adequat ate f e fund nding ing for or cr crit itical ical statewid ide p prior iorit itie ies -DDS DSD -PHD/ERD 1. Elim imin inate t e the 1 13.5 .5 year ar DD DD Waiv iver er Wait iting ing lis ist -DHI -FACILITIES 2. Impa pact popu populat ation he heal alth by: -SLD a) Reducing transmission of infectious diseases via increased vaccination rates and syringe services b) Addressing substance use disorder 3. Provid ide o oversig ight an and d qualit ity of y of ca care in in New M Mexico xico’s ’s boar ardin ing hom omes, h hos ospit itals, cr , cris isis is triag iage ce cent nters, and , and other f facil cilit itie ies 4. Improve s Im saf afety n net ser ervice ices f for or the elderly, v , veterans, and others in and in the DO DOH facil acilit ities ies an and d com commun unit ity pr prog ogra rams 1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

DD Waiver Trends Since FY2011 10 Wait ait L Lis ist DDSD DDS 5,500 PHD/ERD DHI 5,000 5,06 5, 064 FACILITIES SLD 4,500 4, 4,47 479 4,000 4,09 4, 091 4,02 4, 029 4,01 4, 011 3,90 3, 904 3, 3,70 700 3,66 3, 666 3,500 3, 3,52 525 3,000 2,500 2,000 FY11 FY12 FY 13 FY 14 FY 15 FY 16 FY 17 FY 18 FY 19 1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

Challenges in Reducing the Waitlist 11 DDS DDSD PHD/ERD DHI FACILITIES SLD • 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) 1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

Solutions that will provide relief 12 for waitlist applicants DDS DDSD • Ensure all who are eligible receive Early Periodic Screening, PHD/ERD Diagnosis, and Treatment (EPSDT) and community benefit DHI FACILITIES • Implement a short-term family supports and reimbursement SLD 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 1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

New Supports Waiver Details 13 • Governor’s Initiative (April 2020 pending funding) • Created to bridge service gap from waitlist to DDS DDSD PHD/ERD allocation for Traditional or Mi Via waivers DHI FACILITIES • Traditional or Self-Directed options SLD • 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 1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

Reforming Existing Waivers 14 DDSD DDS MI I VIA IA W WAIV IVER ER PHD/ERD TRADIT DITIO IONAL DD DD WAIV IVER ER Review Outlier Budgets to determine DHI • causation • Adopt Standardized FACILITIES Assessment Tool (for both Strengthen the Service Criteria to SLD • Inform Third Party Administrator waivers) (TPA) Increase oversight through Incident • Management Bureau (IMB) to detect • Review Outlier Budgets to ANE determine causation Increase oversight through Quality • Management Bureau (QMB) for provision of services • Implement the Supports Waiver Engaged with (NASDDS) National • Association of State Directors of Developmental Disabilities Services for technical assistance to improve oversight of the Mi Via waiver 1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

DD, MF, & MI VIA Rates 15 DDS DDSD PHD/ERD • Based on CMS Required Rate Study DHI performed by independent experts FACILITIES SLD • Examines current “cost of doing business” DD Waiver: 19% Underfunded Med Frag: 37% Underfunded Mi Via: 17% Underfunded 1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

Ca Caseload d Gr Growth in in Famil ily 16 Infan ant Toddle ler DDSD DDS PHD/ERD DHI • FIT had an average annual growth of 5%. FACILITIES • FIT is moving from DDSD to ECECD in FY21 SLD • 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. 1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

Drug Overdose Death Rates 17 New Mexico, 1991-2018, and U.S., 1991-2016 DDS DDSD PHD/ERD 30 DHI 26.6 Deaths per 100,000 FACILITIES 21.7 20 SLD Population 10 7.9 3.7 0 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 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 1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

Alcohol-Attributable Death Rates 18 New Mexico, 1990-2018, and U.S., 1990-2016 DDS DDSD PHD/ERD 80 DEATHS PER 100,000 POPULATION DHI FACILITIES 60 SLD 40 20 0 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 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 1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

DDSD DDS PHD/ERD DHI FACILITIES SLD The gra The raph a above s sho hows tha hat t the he ra rates of of neon onatal 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 of 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 of al all bab abie ies b s born exp xpose sed to su subst stan ances. . 19 1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org