Monday, December 17, 2012

Kewa Workgroup meeting notes 12/14/2012


 

 

Discussion topics

UNM expansion hospital

Letter from Greg Ortiz urging Tribal Leadership to get involved in advocating for the construction of the Proposed Adult Hospital

·         Will not impose any new Taxes or mill levy for Bernalillo County residents and will help honor the UNM 1952 contract agreement with Pueblos.

·         Construction was halted after opposition in NM Legislature and Bernalillo County commissioners

 

Dismantling of the DOH office of Native American Health

Dr. Ron Reid Director of ONAH requests assistance in raising awareness of the unilateral dissolution of the Office of Native American Health, by the DoH Secretary prior to her resignation, without any Tribal consultation.

·         This is another example of the State of NM (Executive) unilaterally making decisions about Tribal Programs without consulting tribes.

 

Tribal Consultation follow up:

·         Identified the major points of contention between the Tribes and the State.

1.      Complete Lack of Meaningful Tribal Consultation between the State of NM and Tribes

2.      Mandatory Enrollment of All Native Americans in to Managed Care Organizations (MCO) Through the Indian Health Care Improvement Act (IHCIA) Native Americans are protected being mandatorily enrolled into Managed Care Programs

3.      Elimination of the “Opt in” ability for Eligible enrolled Native Americans in the Medicaid Program Native Americans have had this option since the institution of the Salud Program in NM and many other Tribes in other states including tribes in AZ and Kansas have similar provisions in their states Medicaid program

4.      Elimination of the Fee for Service Component from the Medicaid program for Native American Population. The fee for service program is utilized and preferred by Tribal Programs and IHS when billing for Medicaid Services, because of prompt payments.  The Fee for service program is going to remain intact for undocumented immigrants in the State of NM

5.      Elimination of the Prior Quarter Coverage “presumptive eligibility” for Medicaid Enrollment. The elimination of this provision will greatly affect Tribal health program and IHS budgets that rely Medicaid reimbursements.

6.      Any individual Native American enrollee cost sharing or Tribal program/facility cost Sharing.  Native Americans are protected from cost sharing through provisions in the ARRA, PPACA and the IHCIA

 

           

·         talked about dialogue between the State and CMS after the Consultation- State is unwilling to alter Waiver after being presented with the Tribes issues brought up at the session and unwilling to sit back down with Tribes to discuss tribal concerns with the waivers contents

1.      After the November 27th meeting with Tribes CMS reps called the State and presented HSD with the Tribes Demands Per IHS and CLP:

 

“Admiral Grinnell and Navajo VP Jim met with Cindy Mann last week, apparently the state received our demands from the consultation on the 27th and has indicated that they don’t plan to meet with tribes again and will not back down from their proposal. No timelines yet relative to a decision.

Rumors started swirling about the approval dates for the waiver and RFP after I informed the Con Alma health policy forum December 30th about the consultation on the 27th and CMS’ plans to meet with tribes again during the first week of January. Apparently, MCO’s and state contractors in attendance got nervous about their paydays and asked the state during the LFC hearing last week. Secretary Squier insisted that everything is on track and that they had been mis-informed. I spoke to our CMS Project Officer Robert Nelb today and he confirmed the following;

a. CMS is working on scheduling a call with the group from the 27th for the first week of January

b. No final decision will be made on the waiver before this call/meeting occurs.

c. The state could go ahead and grant the contracts on January 7th anyway, but they will have to be amended if any part of the waiver isn’t approved.”

 

·         Next consultation with CMS will be Conference call in first week of Jan 2013,  this is a major concern with the group because the proposed call is expected to be the 6th  or 7th of January 2013, as you all know new leadership will just be taking office and will be expected to participate in this CMS Call!?  We as a workgroup need to do two things, contact CMS and ask for a later date and educated incoming leadership as to the situation with the State and CMS

need to educate new leaders/councils

 

Medicaid Expansion

Small good news Governor Martinez is leaning more towards accepting Exchange as part of a “bargin” to get the exchange passed her way. CLP reported after having a one on one conversation with Governor Martinez

 

NMHIX

·         There isn’t much to report on the exchange other than the Blue print was transmitted to CMS on Friday December 16th

·         It was pointed out that NA while will be able to take advantage on the Exchange we are protected for the Mandate to purchase Insurance

·         The NA workgroup of the HIX is talking about what the Native American Service Center is suppose to be its function and role within the Exchange

 

Action Items:

 

Obtain resolutions from AIPC on Medicaid Expansion and Centennial Care from Ken Lucero

 

One pager on Centennial Care for Leadership

 

Five to Six pages on Centennial Care for Tribal Councils Health Departments/workers

 

Letter from Governor Magdalena to other Governors urging involvement in educating incoming leadership on Centennial Care

 

Need bullet points to April on focus of letter ie. major points/ concerns for your pueblo

 

Form a small Group to go to each Tribe (if need be) to Educate Leadership and Councils so that we have a unified voice when speaking to State and CMS

(Erik April volunteer so far)

 

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