Commentary: WASHINGTON D.C. – Congresswoman Michelle Lujan Grisham sent a letter today urging the U.S. Department of Health and Human Services to immediately investigate the Martinez administration’s decision to terminate its contract with the Non-Metro Area Agency on Aging which provides critical services like adult day care, meal services, caregiving, transportation, and respite care for tens of thousands of vulnerable seniors throughout New Mexico.
“When New Mexico recklessly terminated its contracts with nearly the entire system of behavioral health providers, there was massive disruption in services, thousands of New Mexicans suffered, and the system has yet to fully recover,” Rep. Lujan Grisham said. “New Mexico’s recent self-inflicted crisis to terminate contracted services for seniors and their families is dangerous, hasty, and appears to have violated federal law and regulations. This massive disruption of services will undoubtedly put vulnerable seniors at grave risk of harm. New Mexicans have died because of the State’s gross negligence and mismanagement, and more New Mexicans will suffer if immediate actions by HHS are not taken.”
Here is the letter to the Acting Secretary of Health and Human Services:
Dear Acting Secretary Hargan,
State Representative Deborah Armstrong has requested my assistance in reaching out to you on a critical and time-sensitive issue in New Mexico. Her letter is attached. Representative Armstrong and I are both deeply disturbed about the New Mexico Aging and Long-Term Services Department (ALTSD) decision to terminate their contract with the North Central New Mexico Economic Development District (NCNMEDD), who operates the Non-Metro Area Agency on Aging (NMAAA). NMAAA, which serves as the AAA for three (3) Planning and Service Areas (PSAs) manages a network of critical services to seniors and their families throughout New Mexico, and I fear that ALTSD’s hasty and reckless decision will cause great disruption and potentially harm thousands of New Mexicans if not quickly resolved.
ALTSD announced their intention to terminate the contract on December 20, 2017 with termination taking effect on February 1, 2018. Given this incredibly short timeframe, NMAAA, will not have an opportunity to respond or resolve the issues ALTSD has raised. In fact, the accusations ALTSD has made of billing and reimbursement issues at NMAAA to justify their decision are vague and ambiguous at best. Furthermore, ALTSD appears to have ignored Section 305 of the Older Americans Act, as well as its own regulations, and does not have the authority to de-designate a AAA without a hearing or opportunity to appeal and, ultimately, without submitting an amended State Plan to the Department of Health and Human Services (HHS) for approval. I would like to know whether HHS is fully aware of this situation and has approved ALTSD’s decision to de-designate the NMAAA. If ALTSD did not seek and obtain approval, this would be a clear and blatant violation of federal law that cannot be tolerated.
Although ALTSD has stated that they will take over the services that NMAAA provides, I am certain that ALTSD lacks capacity to seamlessly assume these responsibilities to ensure continuous care for seniors and their families. As a AAA serving three PSAs, the NMAAA had close to 30 staff throughout the state to oversee Aging Network operations. I don’t believe the State is in a position to step in at that level of staffing and it is unclear how they intend to manage the level of work required to manage a statewide system. One issue is the mere fact that provider contracts are with the NMAAA - not the State. All provider contracts will need to be redone, which seems impossible to accomplish by February 1, 2018, given that no provider with whom I’ve spoken has yet heard from the ALTSD as to specific plans for transition. The contracting issue, alone, has the potential to cause a massive disruption in services, which will put vulnerable seniors at grave risk of very real harm.
Also, the Older Americans Act only permits a state agency to assume direct operations for an AAA for a maximum of 180 days. It is unclear whether ALTSD has a plan after this time frame. This means that thousands of New Mexican seniors and their families will be left without critical services. Although it is hard to imagine this level of negligence, I am, unfortunately, all too familiar with New Mexico state agencies failing to live up to their responsibilities. A few years ago, when New Mexico unnecessarily terminated its contracts with nearly the entire system of behavioral health providers, there was massive disruption in services and thousands of New Mexicans suffered and the system has yet to fully recover. New Mexicans have died because of the State’s callous and irresponsible decision. I will not tolerate a similar disaster.
Before my election to Congress, I served as Secretary of ALTSD, and I recognize the challenges that New Mexico faces in providing adult day care, meal services, caregiving, transportation, respite care and other services for tens of thousands of vulnerable seniors in our state. As a result of ALTSD’s decision many lives may be at risk and people will die. Since the termination takes effect so soon, it is impossible for the due process required under the Older Americans Act and state regulations to occur; namely, a public hearing and opportunity to appeal. NMAAA, providers, and seniors all have a right to be heard, although I suspect that ALTSD is attempting to prevent this by moving so quickly. I insist that you immediately use your oversight authority to investigate ALTSD’s decision. Specifically, did ALTSD violate the Older Americans Act and do they have a plan to provide the services of NMAAA without disruption?
A prompt response is necessary to prevent a tragedy. I stand ready to work with you to ensure that New Mexicans continue to receive these critical services without interruption.
Michelle Lujan Grisham
Member of Congress