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Audit Critical of N.M.’s Developmental Disability Waiver Program

ALBUQUERQUE, N.M. — The legislative audit could lead to changes in how the program is structured

SANTA FE — New Mexico’s developmental disability waiver program is inefficient at targeting services, costs too much and needs to be managed better, a legislative audit released Wednesday found.

The Legislative Finance Committee audit could lead to changes in how the program — which offers home and community-based programs as an alternative to institutionalization — is structured.

However, the heads of the two state agencies that oversee the program said Wednesday that paring back or “redesigning” the $300 million waiver program would be no easy task.

“There’s very little you can put on the table that’s considered emotionally neutral,” Health Secretary Alfredo Vigil told legislators.

Most recently, budget cuts proposed in January for family caregivers who participate in the program were put on hold after the plan encountered fierce opposition from advocates of the disabled.

The developmental disability waiver program provides state and federal funding for nearly 4,000 disabled New Mexicans of all ages. An additional 4,700 individuals are on the program’s waiting list.

“The bottom line is we have more needs than we have revenue to pay for the needs,” said Rep. Donald Bratton, R-Hobbs.

However, while similar programs in other states have a majority of clients classified as needing a moderate level of care, most New Mexico clients are classified in the highest, and most costly, care level, the audit found.

Sen. John Arthur Smith, D-Deming, said he’s concerned some individuals are “gaming the system” by funneling clients to certain care providers. The LFC audit highlighted at least two cases in which individuals were operating case management agencies and referring clients to their spouses’ treatment facilities.

“The bottom line is we are searching for greater efficiency in a timely fashion,” Smith said.

State spending on the waiver program increased by about 33 percent from 2001 to 2008, the last year that was included in the audit. The state spent an average of about $71,000 per person for program participants in the 2008 fiscal year.

Among other recommendations, the audit suggested state agencies should begin reviewing the eligibility of individuals on the program’s waiting list and investigate cost-saving measures.

Vigil said the Department of Health is working on a review of its rates.