More Press Coverage of the Forum

Nashua Telegraph: "Disabilities, rights grab spotlight at forum"

New England Cable News video clip (uncaptioned): "Candidates try to persuade undecided NH voters"

Concord Monitor (New Hampshire): "Vying for voters with disabilities"

WCAX-TV 3 News (Vermont): "Advocates for the disabled host presidential forum"

Comments

[Philip B Kirschner]

“New Mexico is a national leader in providing Home and Community-Based Services for Medicaid-eligible clients requiring long term care and services, with nearly 70 percent of available Medicaid funding for long-term services going to home and community-based services. The Governor signed MFP legislation because he embraces the same goals that are contained in the array of approaches that the Human Services Department, in partnership with the Aging and Long-Term Services Department, already offers.

Since 2006, the administration has been working with stakeholders to further develop the Medicaid long-term services program, and is adhering to the legislation that directed the ALTSD to implement a “money follows the person” approach However, any change in health and human services Medicaid-funded programs requires federal approval. (New Mexico receives 71.5% of its Medicaid funding from the federal government.) The request for federal approval for changes to New Mexico’s long term services plan will be submitted in the near future for a July 1, 2008 implementation.

Facts about Money Follows the Person and Medicaid funded Community-Based Services in New Mexico
• Under the Governor Richardson administration New Mexico has increased the percentage of available Medicaid funding to community-based services, versus institutional long-term services.
• New Mexico is second in the nation with 67.2% of available funding used for community-based services, only behind Oregon with 70.1%.
• Community-Based Services already available in New Mexico include:
o The Program for All Inclusive Care for the Elderly (PACE),
o The Disability and Elderly Waiver Program,
o The Mi Via Self-directed Waiver Program,
o Personal Care Option,
o The Developmental Disability Waiver,
o The Medically Fragile Waiver Program, and
o The HIV/AIDS Waiver Program.
• ”Money Follows the Person in New Mexico Act” (MFP) was passed during the 2006 Regular Legislative Session as HB 353, sponsored by Representative Edward C. Sandoval. MFP is supported and was signed by Governor Bill Richardson on March 8, 2006.
• The MFP Act is intended to give an individual living in a long-term care facility the opportunity to reintegrate into the community with a choice of community-based service options that best meet that individual’s needs. The idea is that when Medicaid funding is being utilized for institutional care it should be made available for a home and community-based service alternative for those individuals who wish to and are able to reintegrate into the community.
• The MFP Act did not include any state funding to study, plan or implement the program. Therefore, funding must come from the federal government.
• The MFP Act states federal approval shall be sought and upon federal approval, implementation shall begin.
• The NM Human Services Department withdrew its previous application for a federal grant to implement a “money follows the person” approach because:
o The federal grant contained an overly stringent requirement that individuals must reside in a nursing home a minimum of six months to be eligible, even though New Mexico has an established reintegration process that requires individuals to reside in a nursing home for only 30 days,
o The federal grant requirements created an undue administrative burden in comparison to the minimal benefits that would be gained.
• The Human Services Department is now applying for a Medicaid waiver that will incorporate “money follows the person” into a more comprehensive Coordinated Long Term Services (CLTS) program, scheduled to begin on July 1, 2008.
During the approval process the State is working with different advocacy groups to plan for and operate a MFP pilot project in the greater Albuquerque area. The goal for the pilot project will be to work together to increase outreach efforts that will identify eligible individuals residing in nursing facilities in the region who want to move to the community, and to assist them with the transition and thereafter by providing needed services, utilizing existing resources and services.

--
Philip B Kirschner
Senior Advisor
Bill Richardson for President, Inc.
o: 505-828-2455
f: 505-842-5785

[bob kafka]

Dear Mr. Kirschner:

You are referring to the federal MFP Demonstration funding which New Mexico decided not to pursue because of request for more information. The MFP legislation passed in New Mexico stated that Governor Richardson should pursue MFP funding "AS NECESSARY". Since Governor Richardson DECIDED NOT TO PURSUE FEDERAL FUNDING he could have done what Texas and other states have done and implemented a state MFP policy that would take existing funds serving a person in a nursing home and use those SAME FUNDS to serve that person in the community using your existing Medicaid waivers and/or your Personal Care Option. It does not require the Federal MFP Demonstration grant money which you decided not to pursue anyway. Governor Richardson is being a little disingenuous by confusing the Federal MFP with what he could do with existing funds at the state level.

The bottom line is that Governor Richardson has sided with the nursing home industry to keep people with disabilities and older New Mexicans in their facilities rather than implementing a state MFP policy.

For an Institution Free America (including New Mexico)

Bob Kafka, Organizer
The ADAPT Community
Bob,

This is not true. The federal government has rejected new mexico’s paperwork and is demanding more information. As you know. States have to file paperwork for this. I would be willing to have this discussion with you, and bring national staff on board, but we have to be honest brokers and discussion. Often in disability politics, the truth is the last victim to fall by the way side. And often we are not willing to listen.

Phil

From: Bob Kafka

Dear Mr. Kirschner:

Your statement that a state MFP process cannot be implemented without Federal approval is not accurate.

Texas passed a state budget rider that allowed money being spent on people in nursing homes to be transferred to our Community Care line item (Medicaid waivers, State Plan services) for serving those same persons in the community.

It is a state's perogative to do it.

Over 12,000 Texas residents of nursing homes have moved into the community using our state MFP. We can supply you with the Texas information so Governor Richarson can keep his word to the disability community of New Mexico.

Advocates all over the country hope Governor Richardson will keep his word and not continue to obfuscate the issue by using the Federal government as the reason he is not implementing MFP.

A candidate for President does not look good if he/she makes promises that are then broken using false information.

For an Institution Free America (including New Mexico)

Bob Kafka, Organizer

The ADAPT Community

[Gil Yildiz]

Dear Mr. Kirschner:

The statements you posted in some form or another has been taughted around New Mexico and written in whole or in part by Governor Richardson's cabinet secretaries of HSD and the ALTSD as a way to justify not implementing MFP which we all know was signed by our Governor and now Candidate for President on March 8, 2006.

The time for debate has long past...we are seeing the very same problems that still exist and without MFP implementation, the following will continue....

The TRUTH is, even with all of the home and community based programs listed in the statement and without MFP, an institutional bias still exists and choice for our folks (individuals with disabilities and older Americans) in Nursing Homes remains LIMITED!!! Last we checked, NM has nearly 1,300 folks who want out of Nursing Homes and would rather live at HOME.

Waivers have slots that require additional funding - word is New Mexico is currently at full capacity for D & E Waiver services and only accepting folks in emergency situations and/or community reintegration. On the ground, we, as an independent living center in New Mexico, are beginning to see folks get rejected for these services. MFP does not take up waiver slots.

Mr. Kirschner, this is probably the first time you are hearing it, but, the disability/independent living advocates in NM have all along communicated with the Governor's Administration that federal approval to move Medicaid dollars from NH to home and community based services is not necessary or required! Governor Richardson and his administration is using this to confuse matters.

Doesn't the Candidate for President know that he has gone back on his WORD. You talked about bad advise. We agree. He's getting lots of it from his administration. Is he leading his state or is his Cabinet Secretaries leading his state??

The disability/independent living community in NM worked faithfully with the administration to design and implement MFP in NM. The federal demonstration grant application (available to our state and all other states) was a way for states to get an enhanced match for Medicaid dollars by implementing MFP and still NM decided not to apply. Mr. Kirschner, we now believe NM did this because they did not want to be accountable for implementing MFP.

We think Governor Richardson is more concerned with the welfare and solvency of Nursing Homes and institutions rather than on the people who are counting on him to keep his word?

This is the first time we're hearing about a "summit for the community in NM." The need for a summit is questionable. Again, Governor Richardson should simply direct his administration to implement the law.

Disability/independent living advocates have previously been denied a meeting with the Governor despite repeated requests to meet over his stance on MFP implementation. We have met with him before at the Governor's office on more than one occasion. And, we stand ready to meet with him now.

Signed, Gil Yildiz and Sherry Watson, the two disability advocates who promoted MFP through the NM Legislature.

Gil Yildiz
Executive Director
ILRC
4401 Lomas Blvd.
Albuquerque, NM 87110
505-266-5022
505-266-5150 fax

[Marsha Katz]

Hi Phil,

My name is Marsha Katz and I'm from Montana. We are like New Mexico in many ways...very rural/frontier/tribal, and very low population density, as well as a small population overall. I have worked in New Mexico repeatedly over the past 8 years and was one of the many people across the country celebrating the passage of NM's MFP-type law. I am also one of the many people across the country who has mourned the recent lack of follow through by the Governor and his administration.

While I have no clue about whatever sticky politics and misunderstandings that appear to have stalled implementation of this law, I can offer a referral to help for your administration to understand how to accomplish what needs to be accomplished.

For a number of years, we here in Montana have been practicing Money-Follows-the-Person without any federal permissions, without an MFP grant, and in fact without anything more than the commitment to do the right thing, preserve the civil rights of people with disabilities and older people, and save money in the process. In fact, a few years ago (about 4-5) as Montana moved people out of the nursing homes they hated into their own homes, the state saved $1 million dollars. That was the good news. The bad news was that the savings, earmarked for higher attendant wages, was taken back by our legislature to address MT's budget crisis at the time.

The good news now is that MT continues to move people out of nursing homes, with no special permission from any federal source, and the legislature has voted to increase attendant wages now that the fiscal picture has improved some.

So, rather than continuing any unproductive he said-she said discourse, and wasting more time trying to start from square one, how about suggesting that your people call our people ( the Community Services Bureau of Montana's Long Term Care Division in our state Department of Public Health and Human Services) and pick their brains aout how to "Just Do It!" as Nike would say.

Thanks for all you do to help New Mexico, the Governor, and his administration to move forward in implementing the law and keeping faith with the aging and disability community and their families and allies.

Sincerely,

Marsha

Marsha Katz
The Rural Institute
University of Montana
634 Eddy 025 CHC
Missoula, MT 59812

[Gil Yildiz]

Mr. Kirschner,

Rumor has been circling around that Governor Richardson wants to meet with the NM disability community. We want a date confirmation by November 21, 2007 with a meeting by December 3, 2007.