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Lawsuit aims at state disability evaluation system

ALBUQUERQUE, N.M. — Advocates for people with disabilities filed a lawsuit Wednesday asking a federal judge to block the state from using a new system designed to evaluate the needs of about 4,200 severely disabled New Mexicans.

The lawsuit was filed on behalf of eight New Mexico families with disabled relatives enrolled in the Medicaid developmentally disabled waiver program, often called the DD waiver.

Parents participating in the lawsuit said Wednesday they have adult children with severe disabilities who have lost services, such as speech, physical and occupational therapy, since the state implemented the new evaluation system in May.

They say additional service cuts are likely.

“The reduction in these services is resulting in real danger to the health and safety of folks with disabilities on the waiver,” said Jason Gordon, an attorney for Disability Rights New Mexico. The group filed the lawsuit with Arc of New Mexico.

Named as defendants are the state Human Services Department, the state Department of Health and secretaries of those agencies.

The lawsuit, filed in U.S. District Court in Albuquerque, asks a federal judge to rule the new system illegal under federal law and restore lost services to DD waiver clients.

The Department of Health responded in a written statement that the new system has allowed the state to trim the DD waiver waiting list, which contains about 6,000 New Mexicans who must wait up to 10 years for services.

The lengthy waiting list “is absolutely unacceptable,” said the statement, issued on behalf of Gov. Susana Martinez’s administration. “Others may wish to go back to an obsolete system that left so many of those in need without the help they deserve, but we do not.”

The lawsuit takes aim at a new evaluation system called the Supports Intensity Scale, or SIS, which state officials have called a proven tool for determining the needs of people with disabilities.

An assessor interviews caregivers and completes an eight-page form that covers activities such as employment, social health and medical needs. The SIS is used to assign DD waiver clients to one of seven groups, labeled A to G, with A being the least needy.

The SIS is used to develop budgets and service packages for DD waiver clients.

Disability advocates said the SIS process uses assessors who don’t know the client and omits input from people who do, including physicians and therapists.

As a result, many severely disabled adults have been assigned to groups A and B, which are intended for people who can live independently with some support services, Gordon said.

John Waldrop, the father of a 44-year-old DD waiver client named as a plaintiff, said he fears his son, Brian, will be forced to move from a group home where he has lived for 13 years because he was assigned to group B.

“Brian can’t read or write,” Waldrop said. “He can maybe count to nine.

“He can’t buy groceries or cook. The people who do the assessment don’t take these things into consideration.”