Rate Study/Legislative Expectations for 2020
By Rosy Rubio
Early 2019, along with other state-wide providers, Tobosa participated in a rate study conducted by PCG through the Department of Health, Developmental Disabilities Supports Division. The outcome of the rate study would provide PCG the opportunity to recommend reimbursement rates commensurate to regulation for individuals receiving services through the traditional Developmental Disabilities Waiver, Medically Fragile Waiver, and Mi Via Waiver.
Based on the information provided by Tobosa and other statewide providers, we were pleasantly but not really surprised that the rates paid through the Developmental Disabilities Waiver were significantly short of the actual cost of providing services. The final report stated DD Waiver rates were underfunded by 19% overall and included programmatic recommendations to improve the outcomes of the system, including an objective assessment process, streamlining administrative practices to include Waiver redesign and implementation of a new waiver to assist people on the statewide waiting list for services. Currently, New Mexico’s waiting list has more people on the list than actually receiving services.
How are we going to cut back/down this list?
Governor Michele Lujan Grisham has committed to a six-year, three-phased plan to eliminate the DD Waiver waiting list. This will involve investing resources that link individuals to program options that ensure MCOs comply with state contracts, implements a support waiver by 2020 for people on the waiting list, and streamlines the existing DD Waiver by applying an assessment tool to better allocate services.
New Mexico and those involved with this vulnerable population understand that a strong, solid, and healthy DD Waiver system is a must for people coming off the waiting list. The system needs a rate structure that sustains a well-trained workforce and assessment processes that can provide specialized services for those children and adults with high general support, behavioral and medical needs. In looking at all services, we should also accommodate those individuals with lesser needs and help them successfully live their lives as they choose.
The process seems overwhelming and challenging. However, New Mexico’s statewide provider system contains the expertise, the experience, and the institutional knowledge to create a comprehensive system that addresses mandated services with proper reimbursement rates while valuing the direct support professionals who can earn a good living wage.
We empower people with developmental delays or disabilities, and their families, to independently fulfill their life goals and dreams.
Tobosa is grateful to everyone that continues to support the organization. Tobosa celebrated 41 years of providing excellent, quality services for children and adults of Chaves County. With the help of our stakeholders, including our area legislators, we firmly believe that New Mexico will fund the rate study recommendations, making Tobosa a better and stronger organization. Tobosa will continue moving forward with its mission to support individuals with developmental disabilities to reach their level of independence.