From the Lead member of the Native American Work Group of the NM HIX Joyce Naseyowma:
Hello Ms. Cowley and Comeaux,
The New Mexico Health Insurance Exchange Native American Workgroup presented recommendations for development and implementation of the health insurance exchange initiative at the regular scheduled meeting of the NM Health Insurance Exchange Task Force on February 27th. There were questions regarding the development of the Native American Service Center which was included in the level grant as a component of a the statewide system to support health insurance exchange outreach and education for the NM Native American communities and populations. The Native American workgroup thought CCIIO might provide further clarification on the matter so we are submitting the attached letter for your response. Included is the budget outlining the resources allocated to support the Center.
The information you provide will useful when our workgroup meets with Tribes and Native American entities to present recommendations and get input.
We look forward to hearing back from you.
Joyce Naseyowma, Lead Facilitator
Health Insurance Exchange Native American Workgroup
Content of Letter to CCIIO:
Joyce Naseyowma Chalan
P.O. Box 27
Cochiti Pueblo, NM
(505) 321-0318
jnaseychalan@msn.com
March 4, 2013
Amanda Cowley
Director of State Health Exchanges
U.S. Department of Health and Human Services
Center for Consumer Information and Insurance Oversight
Nicole Comeaux
Health Policy Analyst
U.S. Department of Health and Human Services
Center for Consumer Information and Insurance Oversight
Dear Ms. Cowley and Ms. Comeaux,
In November 2011, the State of New Mexico was awarded a Level I Establishment Grant to develop the New Mexico Health Insurance Exchange (NM HIX). Included in the grant was an initiative designed to create a Native American Service Center to ensure that the NM HIX is accessible, complies with American Indian components of the Affordable Care Act (ACA) and Indian Health Care Improvement Act (IHCIA), and facilitates meaningful, ongoing tribal consultation.
The budget for the Native American Service Center included the following line items:
| Tribal Consultation | $337,500 | |
| Tribal Outreach/Education | $265,000 | |
| Assistance to AI/AN Individuals and Small Businesses, Appeals, Complaints | $347,500 | |
| Native American Service Center Staffing | ||
| Service Center Director | $143,000 | |
| Service Center Program Manager | $195,000 | |
Total
| 1,288,000 |
In July 2012, the New Mexico Human Services Department (HSD) convened a Health Insurance Exchange Advisory Task Force to assist HSD as it established a state-based health insurance exchange in New Mexico. During the first Task Force meeting, Pueblo of Laguna Governor Richard Luarkie urged HSD to establish a Native American Work Group to develop specific recommendations for the Task Force related to American Indians and the Health Insurance Exchange.
The Native American Work Group (NAWG) has met regularly since October 2012 and I presented their recommendations to the NM Health Insurance Exchange Advisory Task Force on Feb 27, 2013. Among several key findings presented by the NAWG was the need to establish the Native American Service Center as described in the Level I Establishment Grant. One of the Advisory Task Force members, Roxane Spruce Bly (who is also a member of the NAWG), asked when the implementation activities to establish the NASC could begin. Mr. Milton Sanchez, Director of the Office of Health Care Reform, responded that all implementation activities had been placed on hold until the New Mexico Health Insurance Alliance has the legal authority to operate as an Exchange. Ms. Bly continued to push Mr. Sanchez on this issue and asked why implementation planning couldn't occur while the legal issues are resolved. Mr. Sanchez stated that he had been directed to place all implementation activities on hold, but declined to identify who had issued this directive.
On behalf of the Native American Work Group, I am requesting the following information:
1. A written explanation regarding how the Level I Establishment Grant funding can be released to begin planning for the development of the Native American Service Center. Mr. Sanchez stated explicitly during the meeting on February 27, 2013 that CCIIO had not put a hold on the Establishment Grant funding or its associated activities.
2. A description of any additional Level I Establishment grant funding awarded to New Mexico and designated specifically for Native American programs and services. During the meeting on February 27, 2013, the Task Force was informed that the New Mexico Human Services Department had submitted a 25% budget increase request for the Level I Establishment Grant. This would result in a potential increase of $8,569,870 and may include additional resources for the Native American Service Center.
As you are aware, the Health Insurance Exchange must comply with a number of provisions in the ACA and IHCIA designed to ensure increased access to health coverage for American Indian consumers. It is imperative that the Native American Service Center exist in order to facilitate access for a large population of Native consumers who have rarely acquired coverage in the past and may have significant cultural and linguistic needs.
The State of New Mexico should utilize the Level I Establishment Grant funding as it was intended and begin the necessary planning to establish the Native American Service Center. Your assistance and guidance is needed to ensure this occurs immediately.
Sincerely,
Joyce Naseyowma Chalan, Chair
Native American Work Group
cc: Governor Richard Luarkie, Pueblo of Laguna
Roxane Spruce Bly, Bernalillo County Off-Reservation Native American Health Commission
Milton Sanchez, Director, Office of Health Care Reform, NM Human Services Dept.
Priscilla Caverly, Tribal Liaison, NM Human Services Dept. Office of the Secretary
Content of the Native American Workgroup Request to CCIIO and budget:
LEVEL 1 ESTABLISHMENT GRANT
$34,279,483 Award Period: November 15, 2011 – November 14, 2012
No Cost Extension granted through November 27, 2013
$ 1,288,000 requested in Level 1 grant for Native American Service Center, programs and services.
The following graphs reflect only those budgeted amounts in the Level 1 grant related to Native American services.
F. BUDGET AND BUDGET NARRATIVE – Pg. 1
New Mexico requests $34,279,483 in federal funding for its Level I Establishment grant for the twelve-month period November 15, 2011-November 14, 2012. Funds are requested for the Human Services Department/Office of Health Care Reform (HSD/OHCR) applicant organization. Sub-awards are requested for NMHIX and the Division of Insurance (DOI). Supplies and travel costs are variable and other costs are fixed.
F. BUDGET AND BUDGET NARRATIVE – Pg. 1
New Mexico requests $34,279,483 in federal funding for its Level I Establishment grant for the twelve-month period November 15, 2011-November 14, 2012. Funds are requested for the Human Services Department/Office of Health Care Reform (HSD/OHCR) applicant organization. Sub-awards are requested for NMHIX and the Division of Insurance (DOI). Supplies and travel costs are variable and other costs are fixed.
Personnel
|
Equipment
|
Supplies
|
Travel
|
Other
|
Contractual Services
|
TOTAL
| |
| Tribal Consultation |
$ 97,500
|
$30,000
|
$10,000
|
$200,000
|
$337,500
| ||
| Tribal Outreach/Education |
$15,000
|
$250,000
|
$265,000
| ||||
| Assistance to AI/AN Individuals and Small Businesses, Appeals, Complaints |
$97,500
|
$250,000
|
$347,500
| ||||
| TOTAL |
$195,000
|
$45,000
|
$10,000
|
$700,000
|
$950,000
|
Pg. 2 & 3
Two program managers are requested to provide staff for stakeholder management and outreach, and program operations development. New Mexico requests three positions to staff the Native American Assistance Center to provide focused technical assistance and support activities for the Tribes and Pueblos. An Executive Assistant and Clerical Assistant are requested for NMHIX administrative support functions. The positions are requested for 12 months of 100% funding from the grant.
Position
|
Salary
|
Fringe
|
Total
|
| Tribal Support Center Director |
$ 110,000
|
$ 33,000
|
$ 143,000
|
| Tribal Support Program Managers (2) |
$ 150,000
|
$ 45,000
|
$ 195,000
|
| TOTAL |
$260,000
|
$78,000
|
$338,000
|
Total allocated for NA Program and Services in Level 1 Establishment = $ 1,288,000
he HIX Task Force meeting held on February 27, 2013 was informed that the New Mexico Human Services Department had submitted a 25% budget increase request on the Level 1 Establishment Grant. This would calculate to an increase of $8,569,870. The Native American Work Group is requesting information on any funding increase designated specifically for Native American programs and services.
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