NMICoA Health Committee commentary to CMS

NMICoA Health Committee

Commentary to CMS

Re: Centennial Care, Medicaid Expansion, Health Insurance Exchange

The New Mexico Indian Council on Aging (NMICoA) Health Committee was developed in 2009 by its late President, Archie Chavez of Sandia Pueblo, in response to  the institution of the Coordination of Long Term Services (CoLTS) Program by the State of New Mexico (NM).  This program during its development phase did not seek Tribal input or consult with tribes in any proactive fashion.  The State of NM Human Services Department (HSD) felt that contracting with Managed Care Organizations (MCO) would vastly improve access to care and diminish disparities in Native American Elder Populations enrolled in NM’s Medicaid program.

The Health Committee has had meetings with HSD since November 2008 and presented issues and concerns to HSD, Aging and Long Term Services (ALTS) and the Indian Affairs Department (IAD) Secretaries, and the Health Committee has noted that Pueblo seniors enrolled in the CoLTS program still have problems accessing services such as Transportation personal care and respite care because providers are mostly off-reservation and cannot bring services to many rural pueblo communities.  We feel more community based Services should be provided via the network of Pueblo senior Centers and MCO’s would upgrade accessibility and services to Pueblo elders and disabled members.

The Health Committee recommends

1. Acceptance of a true Government-to-Government relationship between Tribes/Pueblos/Nations with the Federal and State Governments
2. Tribal/Pueblo/Nations Sovereignty be fully recognized and accepted by NM State Government and the US Government
3. The Federal obligation be maintained in maintaining Health care programs and funding for Tribes/Pueblos/and nations in NM.
4. NM HSD needs to be transparent in development of its medicaid 1115 Waiver plan with active interaction, consultation, input from Tribes/Pueblos/Nations
5. NM HSD has also not provided adequate outreach and Tribal involvement in developing its  Health insurance exchange until very recently.  NM HSD has not developed the proposed special, office of Indian outreach and education with any discussion or input from Tribes and Tribal Health organizations.
6. The health committee also recommends Medicaid Expansion for Indian people on and off reservation this program need full information outreach to Tribes/Pueblo/Nations explain the benefits and access to care that will be improved for this population.  The Health Committee understands the 100% Federal Medical Assistance Percentage (FMAP), and 138% Federal Poverty Level (FPL) will improve insurabillity of up to 25,000 more American Indian.  The Government of NM has not committed to approving the Medicaid  Expansion in NM and this decision should also be from Tribal Governments on behalf of this very vulnerable population.
7. The health committee is in discussion with current Pueblo leaders and will continue to evaluate better practice models to long term care fro Pueblo seniors and disabled members to improve clinical behavior and social services for this population in need of these services.

Respectfully submitted,

Florence Chavez, Pueblo of Sandia

Vice President NMICoA

Manuel Cristobal, Pueblo of Santa Ana

Pueblo Councilman, NMICoA Health Committee Member

Joe Cherino, Pueblo of Taos

NMICoA Health Committee member

Kay Ray, Pueblo of Laguna

President Elders Association, NMICoA Health Committee Member

Leonard Armijo, Pueblo of Santa Ana

Pueblo Councilman, NMICoA Health Committee member

Eloise Smith, Pueblo of Laguna

NMICoA Health Committee member

Robin Clemens, Pueblo of Acoma

Senior Center Director, NMICoA Health Committee member

Ron Lujan, Pueblo of Taos

NMICoA Health Committee member