After a long afternoon of hurry up and wait, HB 376 Receives a unanimous "DO PASS" From the Senate Judiciary Committee. Representative Madalena presented along with Governor Tafoya of Santa Clara Pueblo, Maria Clark from Jemez Pueblo Health Center, and Erik Lujan from the NMICoA Health Committee. Commentary was short but there was support from Acoma, Jemez, Mescalero Apache, Santa Clara, Sandia, San Felipe, Zia.
The only opposition came from HSD Deputy Director Brent Ernest who cited that through Centennial Care NA will be able to access lot more health care resources. He also referenced the "dozens of Consultation and discussion sessions" that HSD has had with Tribal Leaders. Deputy Director Ernest did reference the letter that was sent to MAD Director Julie Weinburg, from Medicaid Director Cindy Mann, earlier this month and stated that there was no more need for HB 376 because CMS directed HSD MAD to exclude all NA from mandatory enrollment into managed care with the exception of the CoLTS population which will still have to utilize and MCO for Services. I stated that the decision from CMS didn't include the elders and the elders object to Managed Care
It is important that HB 376 moves forward because it will include the CoLTS population into CMS's decision to exclude NA from mandatory enrollment into Manage Care. It will become state Law and will set a precedence for all attempts to mandatorily enroll Medicaid eligible NA in managed care in the future.
Good Work Everyone
From the Center on Law and Poverty:
Good morning, Everyone,
At 8:00pm on Saturday evening, the Senate Judiciary Committee gave HB 376 a unanimous “do pass” vote. We were ably represented by Santa Clara Governor Bruce Tafoya, Jemez HHS Director Maria Clark, Policy Analyst and NMNICOA Health Committee Erik Lujan, San Felipe Tribal Administrator Debra Haaland and San Felipe HHS Program Manager Keith Radcliffe with supporting statements from Dr. Ron Lujan and AIPC Health Committee Chairman Ken Lucero. There was strong support from tribal lobbyists and Indian advocates. Human Services Deputy Director Brent Ernest spoke on behalf of the Department but did not mount a credible defense. He reiterated the position presented in the earlier Senate Indian and Cultural Affairs Committee hearing that Centennial Care will provide for better health outcomes and responds to HSD’s intention to streamline Medicaid administrative functions. He recognized that a managed care arrangement might result in loss of revenue for tribal healthcare facilities but asserted that would result from managed care enrollees receiving better care elsewhere. I have cringed at that position as have others but the statement only confirms what tribal healthcare staff have voiced throughout the journey to passage of HB 376.
A major flaw in HSD’s approach to tribes regarding Centennial Care has not only been its failure to adhere to the State-Tribal Collaboration Act but also its complete disregard of the health status advances brought about over the years by tribal administration and operation of health care services. In the follow-up effort to successful passage of HB 376, it will be important to give attention to health care data systems so that the full victory that will arrive in a few days will be secured. It will also be important to maintain the Centers’ on Medicare and Medicaid Services recent ruling that “Native American Medicaid beneficiaries will have the opportunity to voluntarily opt-in to manage care. The terms and conditions will promote and encourage voluntary enrollment but there will be no expansion of mandatory managed care enrollment for Native Americans.” A number of people have called for a meeting after the legislative session has ended to hold discussions regarding follow-through and other issues that need attention. When Judiciary Committee member Senator John C. Ryan (R) asked the panel why the Indians would need HB 376 in light of CMS’ ruling, NMNICOA Health Committee Chairman Erik Lujan responded that our elderly population is still required to enroll in CoLTS. Included in CMS’ March 5, 2013 statement of terms and conditions is the following: “Required enrollment of Native American beneficiaries who meet nursing facility level of care or who are dually eligible in managed care, as is the case today under CoLTS.” The elderly and their advocates have long called for more control of these resources so that they and their communities can have a greater role in design and provision of elderly care services that make it possible for them and their progeny to be present and active members of their villages and homelands. These concerns respond to modernity’s social pressures to reduce the size of the family to a small nuclear base that contradicts the structure of tribal social systems and societies.
We all wait to hear when HB 376 will be referred to the Senate floor which will be our last hurdle before it is sent to Gov. Martinez for her signature or veto. The efforts that have been made to reach out to Republicans to accomplish passage of HB 376 can be extended. They can be asked to convey to the Governor the importance of this legislation to Indian people. As soon as I learn, word will be sent out.
Best regards,
Evelyn Blanchard
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