NM Political Report: Thousands of overdue applications still eligible for Medicaid payment

Republished with permission from the NM Political Report. Click here to read the original article here.

By Joey Peters

An advocacy group says data in a legislative report confirms suspicions that a majority of pending Medicaid applications in the last two years were eligible for benefits.

For Sovereign Hager, a staff attorney with the Center on Law and Poverty, the fact that the vast majority of those applications were still eligible for benefits is vindication of her organization’s legal battles with the state on the issue.

According to figures from the state Human Services Department, which administers the federal Medicaid and Supplemental Nutrition Assistance Program, the department saw 223,000 overdue renewal applications for Medicaid benefits between May 2014 and December 2015. The state agency estimates 97 percent of those applications met Medicaid requirements, despite being overdue.

“These overdue cases are the ones HSD would like to close for procedural reasons,” Hager said.

She’s referring to a May 2014 court order that barred HSD from automatically denying unprocessed Medicaid and SNAP cases. The state agency had been automatically denying all cases that it hadn’t processed within 30 days ever since it changed its IT servers in the fall of 2013.

That court order came after the Center for Law and Poverty filed a legal motion to force HSD to follow requirements from a 1991 consent decree born out of a lawsuit against the state.

The lawsuit, filed in 1988 by Debra Hatten-Gonzales, accused HSD of jeopardizing Medicaid and food stamp eligibilities. The Center on Law and Poverty contends that in 25 years, HSD has never properly followed the consent decree.

Next week a federal judge will hear the Center’s motion asking for HSD to be found in contempt of court. The Center wants the judge to appoint independent expert to oversee key functions of the state agency until the state complies with the consent decree. Some lawmakers are joining in on the call for independent oversight.

“It really is a concern,” state Sen. Howie Morales told NM Political Report. “HSD is not addressing these issues unless a court orders them to.”

Though Hager contends the eligible overdue Medicaid applications since 2014 came thanks to the lawsuit, HSD attributes only 3 percent of them to the ongoing litigation. The state agency attributes the rest of overdue applications that otherwise meeting benefit eligibilities to Medicaid expansion from the federal Affordable Care Act.

A spokesman for HSD didn’t return a voicemail left Thursday by NM Political Report seeking comment.

The memo also estimates the lawsuit has cost the state $5.4 million since 2014. Most of that money—$3.4 million—is from administrative costs. The rest come from additional Medicaid costs.

The Legislative Finance Committee report also warns that an appointed independent monitor could “pose a significant financial risk.”

Morales acknowledges that costs are “a concern” but “not an underlying issue.”

“The underlying issue is HSD not following the law,” Morales said.

It’s a contention that HSD, which has accused the Center on Law and Poverty for not being “cooperative” or “constructive” with the process, doesn’t agree with.

In an April 11 letter to the Legislative Finance Committee, HSD Secretary Brent Earnest writes that his department “is in substantial compliance with the Debra Hatten-Gonzales court orders” and has made recent efforts to “streamline the application process via online and over-the-phone applications.”

“The department has put together a multi-disciplinary team of individuals that are focused on meeting the requirements of the DHG lawsuit,” Earnest wrote. “It is the department’s plan to continue to comply with the requirements of the consent decree and disengage from the lawsuit as soon as possible.”

The Legislative Finance Committee compares the potential independent oversight of parts of HSD to what recently happened to the California Department of Corrections. There, an independent monitor has overseen the state’s prison health care since 2006. That year, the oversight cost the state $882 million. By 2009, the costs skyrocketed to nearly $2 billion.

But Hager says this comparison is unfair. Instead, she refers to “churn”—known as the process when people eligible for benefits have an application rejected and then reapply—as in itself costly to a state.

This type of churn in Philadelphia cost Pennsylvania $9 million in “unnecessary administrative costs,” according to a 2015 Center on Law and Poverty analysis,

“Were it not for the lawsuit, those people would have reapplied and it would have cost the state money,” Hager said.

Santa Fe Reporter: A Broken Process

New Mexico is still struggling to comply with a decades-old court order to ensure benefits for indigent people

Republished with permission from the Santa Fe Reporter.
Click here to read the original article.

By Steven Hsieh

Abby Knowlton drove to the offices of the Santa Fe Income Support Division on March 23, 2015, to apply for Medicaid and food stamps. She pulled a slip from a number dispenser and sat down to wait. Along with dozens of other applicants, she answered questions on a form: Did she have income? No. Kids? No. Had she ever traded food stamps for guns or ammunition? No.

After hours—enough time for Knowlton to drop by her mother’s house for a snack and bathroom break—a Human Services Department worker called her to the front window. After reviewing her paperwork, she was approved.

Applying for assistance wasn’t originally in her plan, though. Knowlton, 33, moved back home to New Mexico to pursue a doctorate in Spanish. She previously worked as an interpreter at a Colorado hospital.

Knowlton always had health problems, including migraines that started when she was a child. One day, during a routine checkup, her blood pressure reading was so high that a nurse thought the machine was broken. Confusion turned to alarm. After running tests, a doctor diagnosed Knowlton with malignant hypertension. Her heart, lungs, kidneys and brain were all losing function and getting worse. Knowlton’s professional career was over.

Days after she was approved for food stamps, Knowlton received a form from Human Services identifying her as a “mandatory work participant.” The printout instructed her to complete a jobs training program “within 15 days of receiving this notice.” It went on to say, “This form must be returned by: (Date),” without indicating a date. If Knowlton had any questions, the form stated, she should call her caseworker. Knowlton had many questions. Among them: Who was her caseworker?

She called multiple toll-free numbers but couldn’t get the answers she was looking for. On a friend’s recommendation, Knowlton contacted the New Mexico Center on Law and Poverty. Attorneys investigated her case and said it was another in a long line of instances where the state’s process for awarding benefits is failing low-income New Mexicans.

Knowlton’s medical condition should have exempted her from New Mexico’s job search requirements, as soon as she applied for benefits, says Sovereign Hager, an attorney at the center. “The law requires Human Services to explain all of this in the interview and screen her for exemptions,” Hager says. “Had they asked, Abby could have explained she is disabled.”

Knowlton’s abundant free time and education helps her navigate the tangles of state bureaucracy. She also keeps meticulous records in a bulging red folder. The same cannot be said for all 230,907 New Mexicans who applied for food stamps or Medicaid in 2015. For many, a procedural misstep by the state can result in a loss of food assistance or health coverage.

“Families shouldn’t need an attorney helping them, because it’s the department’s obligation under federal and state law to provide assistance to people in an accessible way,” Hager says.

Human Services’ own data shows that the department improperly closes cases 47 percent of the time.

In 1991, the department entered into a consent decree, agreeing to comply with laws regarding the processing of Medicaid and food stamps, officially called the Supplemental Nutrition Assistance Program (SNAP). But advocates say the state has repeatedly violated its terms. In 2013, when the Human Services Department switched to a new computer system, thousands of New Mexicans were automatically dropped from their SNAP benefits; a judge ordered the end of this practice. And in January, the court struck down increased penalties for noncompliance with requirements for food stamps.

Most recently, lawyers recommended that the court appoint a third-party “expert” to oversee functions related to the consent decree. For more than two decades, state officials have failed to implement fixes to a process that illegally delays or drops benefits, a court filing claims. Calls to customer service representatives often go unanswered.

A spokesman for the department did not respond to a request for comment for this story before presstime. Later, Kyler Nerison issued this statement: “We disagree with [the Center on Law and Poverty]. The Department is in substantial compliance with the court’s consent decree. [The center] has not been cooperative or constructive with this process and they continuously attempt to redefine the standards for compliance.”

Eleven days after her first trip to the Income Support Division, Knowlton returned with her medical records and a note from her doctor exempting her from the work requirements. She was able to keep the food assistance.

That would not be the end of her frustrations, though. In January, she applied to renew her SNAP benefits. According to her lawyers, she is eligible for a 24-month recertification, but workers granted Knowlton just three additional months of benefits after failing to schedule an interview with her, which Hager says violates procedures. After Knowlton’s attorneys followed up, the state acknowledged its oversight and granted her a yearlong recertification.

“It’s just always a pending, unclear mess,” Knowlton says.

Knowlton periodically logs onto a website set up for New Mexicans to check the status of their benefits. On Friday, the row for food stamps read: “This section is unavailable to view.”

See more at: http://www.sfreporter.com/santafe/article

Anti-poverty group: HSD needs federal monitor

Republished with permission from the NM Political Report. Click here to read the original article here.

By Joey Peters

Tens of thousands of New Mexicans are put at risk because of the state’s continued failure to adequately provide health care and food benefits to the poor, according to a legal motion filed by a group seeking to protect low-income residents.

Later this month, the New Mexico Center on Law and Poverty will argue that a federal court should appoint an independent monitor to oversee some of these key tasks from the New Mexico Human Services Department.

human-services-department

It all stems back to a decades-old federal consent decree that advocates say the state is still struggling to meet.

Issued in 1990, the consent decree came as a result of a class action lawsuit that accused HSD of failing to provide food stamps and Medicaid benefits to recipients.

“The state wasn’t processing [food stamp and Medicaid] applications on time. People weren’t getting their benefits,” Sovereign Hager, a staff attorney with the Center on Law and Poverty, said in an interview. “The state agreed and it resulted in this order.”

human services departmentBut under the leadership of multiple New Mexico governors, HSD has still never been under full compliance of the consent decree.

The call for a monitor comes over the handling of specific sections of the consent decree.

Hager says things really came to a head in 2013, when HSD switched to a new IT system. The change led to the automatic denial of federal food assistance benefits, officially known as Supplemental Nutrition Assistance Program, to between 10,000 and 30,000 applicants.

“Federal law requires the state to look on the last day, make a decision and give notice of who’s at fault for the application not being processed in time,” Hager said.

Instead, HSD automatically denied these unprocessed cases in the fall of 2013, Hager says. The Center on Law and Poverty filed a motion accusing this practice of being illegal.

As a result, a federal court ordered HSD to stop “all procedural denials and closures” on SNAP applications.

As part of an agreement, HSD then allowed the Center on Law and Poverty to review two random samples of cases the department marked as “ready to deny or close,” according to the Center’s recent legal filing.

To its “shock,” the Center on Law and Poverty said in a legal filing it found only more problems with the state’s handling of federal benefits for low-income residents, including a backlog of 129,000 SNAP and Medicaid cases.

Since 2013, the Center on Law and Poverty has filed five court motions to try to get HSD to comply with the consent decree. Now, the organization is asking for the federal monitor.

HSD, according to the legal filing, is not properly delivering delay notices, conducting SNAP interviews on time, or issuing proper renewal notices. The legal advocacy group also faults the state department for using an outdated phone system and requiring “excessive Medicaid verification” requirements for applicants.

The Center on Law and Poverty wants the court to appoint a mediator to oversee these parts of HSD until it comes into full compliance with the consent decree.

An HSD spokesman didn’t return an email and voicemail message left Monday seeking comment for this story. But in a response to the Center on Law and Poverty’s legal filing earlier this month, HSD counsel calls the request to appoint a monitor an “extraordinary remedy” and says the advocacy group has not proved the department failed to take “all reasonable steps” to comply with court orders.

HSD instead contends it’s in “substantial compliance” with the consent decree. The department also criticizes the Center on Law and Poverty for not being “cooperative” or “constructive” with the process.

HSD blames its problems to meet federal requirements on “the complexity involved in compliance” with the consent decree. The department maintains that the “real confines” are working with outside companies it contracts with “to program necessary IT changes.”

“The changes being made are very complex, HSD’s task is large, and the recognition that to effectuate change requires time reflects reality,” HSD’s legal response reads.

The department also blames its failures on “new requests made by Plaintiffs.”

Hager, for her part, denies that requesting a monitor to oversee HSD compliance with federal law is extreme.

“We don’t want the state to pay fines or do anything punitive,” Hager said. “They need the leadership and the expertise to get things done.”

Op-ed: Court was right to halt bungled SNAP rules

By Gail Evans, Legal Director NM Center on Law and Poverty

Published in the Albuquerque Journal, Monday, March 28th, 2016. See the original article at http://www.abqjournal.com/747133/opinion/court-was-right-to-halt-bungled-snap-rules.html

Earlier this month, a federal court halted the latest effort by Gov. Susana Martinez’s administration to revise the state’s SNAP food assistance program because the revisions were illegally denying food assistance to people in need.

A recent editorial by the Albuquerque Journal blasted the New Mexico Center on Law and Poverty for bringing a lawsuit to prevent this effort. However, a very basic review of the facts reveals the suit halted a bureaucratic nightmare that left people in our state without either food aid or job opportunities.

The governor has wanted to revise state SNAP policy to penalize people receiving food assistance who do not meet certain work requirements. However, each attempt to impose these requirements has been a disaster.

When the Human Services Department first tried to do so, in 2014, a state court found that the agency’s rules were so incoherent that they could not be deciphered. The department tried again this year, but a federal court found they were not implementing the penalties fairly or in accordance with the law.

In the hearing, Judge Kenneth Gonzalez heard testimony from the department’s own employees that they had no way to track who had been meeting work requirements and who had not. They admitted that the department’s notice procedures were inadequate and that caseworkers were not trained. They admitted that chronically ill and homeless individuals had been wrongly classified as ineligible for exemptions. They heard testimony from people who were wrongfully denied food assistance and learned of some 12,000 New Mexicans directly affected by this bungling.

The evidence was so clear and overwhelming, the judge ruled that the department must cease applying penalties until it demonstrates it can apply them within the law.

One of the roles of the New Mexico Center on Law and Poverty is to ensure that laws like this, which impact low-income New Mexicans, are well designed and implemented. When they are not, we seek to get the problem repaired.

Our staff spent many hundreds of hours over the past two years trying to get the state to do this one right. But the state Human Services Department, with major deficits in funding and administrative expertise, has so far failed, causing harm to people in trying. Judge Gonzales was absolutely right to stop them.

All of the witnesses in this case want to work and need help finding work. Low-income New Mexicans are not lazy or cheats. The problem is that they are living in a broken state education system and a flailing economy, among the worst in the nation on both counts.

The very least our state government can do during times of crisis is effectively and efficiently administer the public safety net that is required by law.

Instead, the Human Services Department is left to serve record numbers of people in need while struggling with inadequate funding and a shallow bench of capable administrators. They are barely able to administer the expanded Medicaid program, which has been the best source of jobs and out-of-state investment we’ve had in the past five years.

It makes no sense for the governor to add to the department’s workload with new SNAP regulations unless they can be implemented properly.

Federal law doesn’t require these regulations in places of high unemployment like New Mexico. But it does require of the very few states choosing to impose them that they be imposed legally and fairly.

People should be notified when they are subject to new regulations. People who are meeting the requirements and those who cannot work, such as people with disabilities or chronic illnesses, should not lose food assistance.

The Journal’s editorial attack on the Center on Law and Poverty and the courts is baseless and misses an important opportunity to help hold our government accountable for policies and practices that are improperly impacting thousands of people.

Governor and Legislature Must Change Course Fast to Fix the Budget Crisis, Put our Families First

Republished from the New Mexico Political Report. Also seen in the Albuquerque Journal and NM Politics.net

Kim-2015-09-23By Kim Posich, Executive Director of the New Mexico Center on Law and Poverty

New Mexico is in a budget crisis. Our state’s economy is in shambles. We have the worst employment rates in the country and revenue projections have dropped over $200 million dollars from just before the session and they could get even worse.

The result of this economic free fall will be continued under-funding of our schools, jobs, economic development and public safety efforts – all the things most important to New Mexicans. Time is running out at the state legislature. If lawmakers do not take clear aim at the challenges we face, New Mexico will strike out for our families and children.

Strike one will be the budget. Deep cuts are coming that will threaten jobs and public safety. Healthcare, driven by Medicaid, is one of the only growing job sectors in New Mexico yet Medicaid is short by over $60 million in the budget being considered by the legislature. If we cut Medicaid by $60 million, we lose over $140 million in federal matching dollars. The Human Services Department has been clear that there is no room to make cuts other than to reduce services and payments to healthcare providers.

Our schools are still grossly under-funded, shortchanging our children and hurting our prospects for attracting and keeping businesses in New Mexico. With the current budget, we cannot invest in our teachers, Pre-K programs and educational initiatives that have been proven to work in preparing children for academic success and graduation.

The budget also underfunds agencies important for public safety. The judicial branch is struggling with its caseload and the corrections department lacks needed staffing. Deep cuts are also in store for the state’s behavioral health system including crisis intervention services. These are all essential to the integrity of our justice and rehabilitation system and ensuring our communities are safe.

Strike two will be failing to raise revenues. There are sensible opportunities to increase revenues without raising taxes and harming our families. One such proposal is delaying recently passed corporate tax breaks for two years. New Mexico cannot afford them right now. Another opportunity is to increase distributions from our $15 billion permanent fund, to provide needed funds to our education system, including early childhood education.

There are also ways to rebalance our tax structure to make it less heavily reliant on working families. According to the Institute on Taxation and Economic Policy, the lowest income New Mexicans are paying a higher percentage of their income on overall taxes than the highest income households. We could modify capital gains deductions that do not benefit most New Mexicans. We could modify income brackets and actually lower taxes for working and middle class New Mexican families who are the vast majority of our residents.

New Mexico is also still sitting on over $1 billion in unused capital funds, as the state auditor’s office has discovered. These funds could be recouped to fill one-time shortfalls and our reserves, and yet little action has been taken by the Governor’s office to mobilize this funding.

Strike three will be public safety. The best antidote to crime is to have good paying jobs, a strong education system and healthy communities. Unfortunately, many of the so-called “tough on crime” bills being proposed in the legislature will be ineffective at reducing crime. If we are serious about our safety, then we must invest in our communities, behavioral health, law enforcement training and the justice system. Right now, our budget lacks in all these areas.

We need to make New Mexico safe. We need good paying jobs. And most importantly, we need a school system that will do right by our children. There is still time to make a turnaround. The Governor and Legislature should step up to the plate to raise revenues. We need our leaders to fund a state budget that addresses our economic crisis and the needs of everyday New Mexicans.