Editorial: Shortchanging the Poor0

Republished from the Las Vegas Optic. See the original column here.

Tuesday, July 19, 2016 at 6:30 pm (Updated: July 19, 6:42 pm)

U.S. Magistrate Judge Carmen Garza has concluded that the New Mexico Human Services Department should have someone looking over its shoulder to help ensure that it complies with court orders and federal law in the administration of federally funded benefits.

According to The Associated Press, Garza is also recommending a contempt finding against the agency, which oversees the distribution of federal food aid and Medicaid health care benefits to the poor.

To be sure, those are merely proposals at this point; the department has 14 days to file its objections, and the department is already saying that it doesn’t agree with everything in the judge’s decision.

Still, it’s unfortunate — though not surprising — that such extreme measures are necessary to get the department to follow the law and to finally comply with court orders that have gone unfulfilled.

The harsh measures being recommended are not surprising because of the striking testimony presented during the court proceedings in the case.

“Caseworkers’ sworn testimony that they were instructed by managers to fraudulently alter applicant information has essentially not been refuted,” Garza said. According to The Associated Press, Garza also noted that managers overseeing supplemental nutrition benefits invoked their Fifth Amendment right against self-incrimination during the proceedings.

The Human Services Department’s office of inspector general and the U.S. Department of Agriculture are investigating that part of the case.

We don’t doubt that the state Human Services Department has a difficult job with tight deadlines and large caseloads.

But it’s also important to remember that the agency exists to serve as a safety net for our state’s most vulnerable residents.

The aid this agency provides helps our state’s poor put food on the table for their families and get medical care for them. Playing games with that aid is unconscionable and wrong.

If it takes a special master looking over the agency’s shoulder to force it to do the right thing, then so be it.

According to The Associated Press, the special master would have expertise in determining eligibility for Medicaid and food aid. That individual would also be knowledgeable with the organizational and computer systems used to manage the state’s caseload.

The New Mexico Center on Law and Poverty, which brought forth the federal lawsuit on behalf of aid beneficiaries, was pleased with Garza’s decision, which was issued Monday.

“The things we have been asking for are very simple,” attorney Sovereign Hager told AP. “Train your workers on what the law requires, make sure the IT system does what it’s supposed to, make sure notices are intelligible and make sense.”

That seems reasonable to us.

NM Human Services Department Found in Contempt, Federal Magistrate Recommends Special Master0

SNAP Logo

Las Cruces, NM – On Friday, July 15, 2016, Federal Magistrate Carmen Garza entered proposed findings that the NM Human Services Department (HSD) be held in contempt for failure to comply with multiple Court Orders and federal law concerning administration of food and medical assistance to eligible families. Judge Garza found that “it is apparent that HSD and its officials have not exhibited the leadership, oversight, or coordination necessary to implement the Court Orders.” Judge recommended the appointment of a Special Master with expertise in food and medical assistance be appointed to facilitate HSD’s compliance with federal law and Court Orders.

The Order comes after three days of evidentiary hearings about HSD’s failure to provide food and medical assistance to families as required by federal law. Judge Garza noted numerous violations of federal law and Court Orders by HSD, finding that worker trainings and notices to families applying for food and medical assistance are “replete with repeated mistakes” and that HSD had not brought state regulations and policies into compliance with federal law. Nor could HSD tell the Court when compliance would be achieved. The Court further noted that testimony by HSD employees that HSD staff have been altering application in order to deny eligible applicants emergency food benefits and improve HSD’s timeliness statistics “was essentially not refuted.”
In entering a finding that the Secretary Brent Earnest should be held in Contempt, Judge Garza noted the Department’s recent willingness to seek expert assistance, stating “While the Court appreciates this acknowledgement, the Court is troubled it took over thirty hours of status conferences, over five hundred pages of joint status reports submitted to the Court, three days of evidentiary hearings on its Order to Show Cause, and testimony by HSD employees alleging fraud on the part of HSD, to which high level officials responded by pleading the fifth, for Defendant to discuss making these types of changes. For the question before the Court, Defendant’s realization has come entirely too late.”

As a remedy for contempt, Judge Garza recommends that the Court appoint and supervise a Special Master to act as a full time advisor and consultant to HSD. The Special Master will have expertise in food and medical assistance programs and will report to the Court on the extent of the Department’s compliance.

Judge Garza stated “Defendant’s inability to fully bring his application processing practices into compliance with the Court Orders has profound effects on the citizens of New Mexico. Indeed, when an eligible SNAP or Medicaid applicant is denied or delayed in receiving benefits, that individual loses benefits he or she may rely on to eat, feed his or her children, or to receive essential medical coverage . . . It is essential for this Court to acknowledge the need for these services to be effectively, efficiently and properly rendered to those who are eligible in this state.”

Attorneys at the Center and Law and Poverty, along with co-counsel Daniel Yohalem and Jane Yohalem, represent the class of plaintiff applicants for food and medical assistance in the case. Gail Evans, Legal Director at the NM Center on Law and Poverty stated, “We are pleased that the Court will appoint and supervise an expert to oversee HSD’s compliance with federal law in providing food and medical assistance. The Department needs expert assistance with important changes that will help the state provide benefits accurately and efficiently. This includes IT changes, the creation of a manual and effective training for state workers and comprehensible notices to families participating in the programs. We look forward to working with the special master to bring the Department into compliance with the law.”

For more information contact Gail Evans at (505) 255-2840/(505) 463-5299 or Sovereign Hager (505) 417-2084.

Read the full press release here.

Read Justice Garza’s recommendation here: Part 1 Part 2

NM Supreme Court Rules that Exclusion of Farm and Ranch Laborers from Workers’ Compensation is Unconstitutional0

workers' rights option 1

Santa Fe, NM – Today, the New Mexico Supreme Court ruled that the New Mexico Constitution prohibits the exclusion of farm and ranch laborers from the protections of the New Mexico Workers’ Compensation Act (Act). In holding for the workers who challenged the Act, the Court said that the exclusion of farm and ranch laborers “is nothing more than arbitrary discrimination and, as such, it is forbidden by our Constitution.” Opinion at 2.

In its review of the history and purpose of the Act, the Court concluded that “there is no unique characteristic that distinguishes injured farm and ranch laborers from other employees of agricultural employers, and such a distinction is not essential to the Act’s purposes.” Opinion at 15.

New Mexico’s farm and ranch laborers are among the poorest of the working poor in our state, and consequently they cannot afford private health insurance. Their work is also very hazardous. Farm and ranch laborers work with heavy machinery, unpredictable animals and encounter harsh environmental conditions. In fact, the parties to the case agreed that farm laborers engage in dangerous work. “[A]s the parties observed at oral argument, farm and ranch laborers are engaged in a risky profession where workplace accidents frequently result from inherently unpredictable working conditions.” Opinion at 43.

Reacting to the decision the New Mexico Center on Law and Poverty’s Legal Director Gail Evans remarked, “We are thrilled that New Mexico’s farm and ranch laborers have the same right to workers’ compensation as all other workers in our state.”

For more information contact: Gail Evans (505) 255-2840/(505) 463-5293 Elizabeth Wagoner (505) 255-2840 or Tim Davis (505) 255-2840

Download the full press release here.

Read the opinion from the NM Supreme Court here.

Two Center Attorneys Selected as Fellows for Prestigious Race-Equity Training0

The Center is pleased to announce that Supervising Attorney Sovereign Hager and Staff Attorney Abuko Estrada have been selected to participate in the Sargent Shriver National Center on Law and Poverty’s Racial Justice Training Institute (RJTI). RJTI is a national training program committed to promoting race equity as an integral part of antipoverty advocacy. Over a six month period, RTJI fellows will participate in a combination of online and onsite learning to develop their skills to successfully address the role racism plays in causing and perpetuating poverty.

As part of their fellowship, Sovereign and Abuko have spent the week in Chicago training with the Shriver Center. Abuko said, “The Shriver Center’s Racial Justice Training Institute has been an inspirational experience. I am excited to put into the action the tools and strategies learned and continue to engage with a great network of advocates across the nation. I am honored to be a part of the training and feel positive it will help to inform and transform the Center’s work and impact in New Mexico.”

Staff Attorney Abuko Estrada
Staff Attorney Abuko Estrada
Supervising Attorney Sovereign Hager
Supervising Attorney Sovereign Hager

Op-ed: HSD needs to do its work more efficiently0

Republished from the Albuquerque Journal. See the original guest column here.

By Ruth Hoffman / Lutheran Advocacy Ministry-NM
originally published Thursday, June 9th, 2016 at 12:02am

Here in New Mexico, we have long struggled with taking care of our most vulnerable families. Recent reports that state workers at the Human Services Department were being pressured into denying emergency SNAP (food stamps) to hungry people and families are very disturbing. For over two decades, a federal court has found HSD’s track record for basic processing of medical and food assistance benefits to be in violation of federal law.

Government is one of the ways that we can work together to address the needs of our communities, and it can make a positive difference in people’s lives. But when government doesn’t work or fails to do its job, it can cause a lot of pain. Just ask a family of four in Hobbs. State workers left them without Medicaid coverage for seven months because HSD had failed to send a renewal notice or to check information the family had already given them.

Or an elderly man from Alamogordo with no income who had his SNAP assistance terminated last August because state workers forgot to send him a legally required notice. After going three weeks without food assistance, his benefits were reinstated, but only after the man went to an Income Support Division office to submit a new application for food assistance.

Whether it involves Medicaid or SNAP, these stories and others point to an unacceptable problem at HSD of improperly denying families needed services and failing to notify recipients about delays. Seniors and low-income families are on their own to figure out how to resolve these issues. Indeed, according to a study by the New Mexico Center on Law and Poverty, HSD failed to send Medicaid clients the required renewal forms 50 percent of the time. Over 65 percent of the time, they failed to alert families about delays in their SNAP applications or about ways to resolve the delays.

As the government agency charged with assisting low-income people, families and seniors, the Human Services Department should implement common-sense steps to improve efficiency and save money. This can be done by eliminating requests for unnecessary documents, making client notices more accurate and understandable, and automating Medicaid renewals.

Additionally, it is critical that HSD provide much better job training, support and resources for the state workers who determine eligibility for badly needed assistance. Creating a comprehensive, accurate online worker manual would help workers process cases efficiently and as required by law.

We believe that we are called to do everything in our power to serve our neighbors. While faith communities throughout our state serve and help people living in poverty and experiencing hunger every day, they can’t do all that is needed and must be done. Our government has a role to play, and the agencies of our government must carry out that role by implementing a benefits system which is efficient and does its best to not put up barriers to accessing the assistance that eligible low-income New Mexicans need.

We know that eligible families are trying to get back on their feet; they are trying to do the right thing. We should expect nothing less from state leaders. Creating a more efficient benefits system won’t solve everything, but it can make a big difference in the lives of families and the people who most need help.

KUNM: Tough Choices After State Delays Emergency Food Aid0

Republished from kunm.org. Listen to the original radio story here.

By MARISA DEMARCO • MAY 18, 2016

Hungry people in New Mexico may have been denied expedited food assistance after their applications were falsified and put on hold. That’s according to testimony from state workers in recent weeks during an ongoing hearing about whether the Human Services Department is fit to process applications.

Despite working seven days a week, Kimberly Jones participates in SNAP to make ends meet. Photo Credit: MARISA DEMARCO / KUNM
Despite working seven days a week, Kimberly Jones participates in SNAP to make ends meet.
Photo Credit: MARISA DEMARCO / KUNM

In December, Kimberly Jones was struggling to get the hours she needed as a home health aide, a job she’s done for 18 years. She was living in a hotel room, and every day, she had to make a choice. “Do I eat or do I pay for the room? Or how can I squeeze them both? Because, you know, the hotel wants their money,” she said. “They don’t care if you eat or not.”

She decided to apply for food stamps. She said the Supplemental Nutrition Assistance Program told her she was eligible for emergency help, and that she should see her EBT card fill up soon. “Food is the only thing that you can do to get by,” Jones said. “To make things a little easier is not having to worry if you’re going to be able to eat.”

According to emergency food stamps rules, the money should have shown up within seven days. But it didn’t, not for weeks. After asking around, Jones found a lawyer focused on poverty issues who helped her make the call to find out what happened. Jones remembered they waited on hold for more than an hour. But when they finally spoke to someone, she said she got her food stamps right then and there. It was February—two months after she applied.

“When you take someone’s food from them, they don’t have anything, and that’s really sad,” she said. “And for them to take that away, it makes you feel like nothing.”
These days, Jones lives in her own apartment. She works seven days a week, from about 9 a.m. to 7:30 p.m. She says she still gets about $75 a month in food assistance and has to make use of church charity programs and food pantries around town. “It doesn’t matter if you have a piece of job or try to have a piece of job, you know, food helps,” she said.
Lawyer Sovereign Hager with the New Mexico Center on Law and Poverty said Jones’ story is common. “Some of the poorest people in New Mexico are being denied those benefits in order to make processing numbers look better,” she said.

In recent hearings, state workers took the stand to testify that applications were changed, falsified, by the division so they showed people who were seeking food assistance had more assets than they did. That way it wouldn’t look like the state was blowing deadlines.

Hager watched high-ranking Human Services Department officials plead the fifth over and over in court—97 times, even when they were asked basic questions. HSD did not respond to KUNM’s half a dozen requests for an interview. So it’s not clear who knew what.

Hager said their inability to answer questions in court speaks for itself. “Well, of course they know what’s going on. If they didn’t know what was going on, they could testify to that,” she said. “So, obviously this goes up to the highest levels. It’s extremely troubling.”

Hager said the feds should investigate the department—and the state auditor should, too. But, she added, people need help now. The center’s asking the court to put a third-party expert in charge of processing applications in New Mexico. “We want the judge to enter an order as soon as possible to that effect just to protect those families,” she said.
Miles Conway said these issues have been going on for a long time and he’s proud of the whistleblowers who put their jobs on the line by speaking out in court. He’s with the public service employees union.

“There are constantly new mandates being handed down from Santa Fe,” he said. “It’s just becoming very difficult to even to do the jobs that these individuals are trained to do, and that they are ethically sworn to do in a certain manner.”

It was sad, Conway said, watching these court hearings unfold, and he’s apologetic to all the New Mexicans who had to struggle to feed themselves or their kids. “I felt bad that we hadn’t been able to connect the dots to find this smoking gun sooner so that we could have begun to make this very serious change in how New Mexico is running its Income Support Division,” he said.

And as for Jones? She said the state has to step up. “I hope they get it right. For us little people, get it right.”

The next hearing is set to begin July 6 in Las Cruces.

*****
The Human Services Department wouldn’t make anyone available for an interview, but right before airtime, a spokesperson emailed a statement saying the department takes the allegations seriously and has launched an internal investigation.

Thanks to Samantha Sonner of KRWG in Las Cruces for contributing to this report.

KUNM’s Public Health New Mexico project is funded by the W.K. Kellogg Foundation, Con Alma Health Foundation and McCune Charitable Foundation. Find more info on our site, publichealthnm.org, along with links to more coverage by our partner KNME / New Mexico PBS.

Panel recommends state reject Medicaid copays, premiums0

Republished from the Santa Fe New Mexican. Click here to read the original article.

By Justin Horwath

A panel appointed by the New Mexico Human Services Department voted Thursday against imposing copays or premiums on low-income patients who receive Medicaid.

Meeting at the state Capitol, the committee voted down the proposal to recommend the department impose premium payments for Medicaid enrollees with an income between 125 percent and 138 percent of the federal poverty level. New Mexicans within 138 percent of the federal poverty level — an annual income of $16,404 for a household of one — or below are eligible for Medicaid.

Abuko Estrada, staff attorney for the New Mexico Center on Law and Poverty, urged a Human Services Department-appointed panel to vote against premiums and co-pays for Medicaid enrollees because of a lack of data about the potential impact. He said the department should look for other ways to find Medicaid savings beyond cutting the benefits package. Luis Sánchez Saturno/The New Mexican
Abuko Estrada, staff attorney for the New Mexico Center on Law and Poverty, urged a Human Services Department-appointed panel to vote against premiums and co-pays for Medicaid enrollees because of a lack of data about the potential impact. He said the department should look for other ways to find Medicaid savings beyond cutting the benefits package. Luis Sánchez Saturno/The New Mexican

The department does not necessarily have to abide by recommendations of the Benefit Package, Eligibility Verification and Recipient Cost-Sharing Cost-Containment Subcommittee. The department appointed the subcommittee after the Legislature passed and Gov. Susana Martinez signed into law a budget bill that directed the department to plug an $87 million shortfall in state funding for Medicaid — which translates into a potential $417 million cut in services due to federal matching money.

Medicaid, also known as Centennial Care, is a state-federal program that provides health insurance to children, the disabled and poor adults. It currently provides primary and emergency care as well as behavioral health services to 766,000 people in the state.

But the number of those who qualify for the program has risen under the Affordable Care Act, which now allows states to bring low-income adults into Medicaid. And those costs are rising faster than the state budget.
In trying to limit the cost increases, the state is moving forward with another set of proposals that would trim reimbursements for many services to doctors, specialists, dentists, therapists and hospitals. Those changes are awaiting approval from the federal government and expected to go into effect July 1.

The subcommittee looking at copays and premiums included those from the health care industry as well as advocates for the poor. Larry Martinez, the regional director for Presbyterian Medical Services, drafted the motion to impose premiums on enrollees.

Ruth Hoffman, director of the Lutheran Advocacy Ministry of New Mexico, voted against the proposal. She said the department should make a report to the Legislature about how it’s responding to the budget language directing it to make cuts to Medicaid.

“We all know this is not going to generate much money at all,” Hoffman said.

Sandy Potter, a vice president for Blue Cross Blue Shield, one of the four insurance companies that oversees Medicaid, agreed. “I just think it’s not going to make a hill of beans,” she said.

Joe Martinez, consumer outreach coordinator for Health Action New Mexico, told panel members they should vote down the motion because New Mexicans newly enrolled in Medicaid are just beginning to understand its benefits.
“Then to impose premiums and cost-sharing, it’s nothing more than making it more difficult and getting another pattern of denial” from the department, he said.

Members also voted down 5-4 a proposal to impose copays on Medicaid enrollees who use hospital emergency rooms for nonemergency care.

Erik Lujan, a subcommittee member with the All Pueblo Council of Governors, said that tribal members often go to the emergency room because it’s difficult to see a specialist on the spot.

Subcommittee members voted in favor of making a recommendation to the department that it impose copays on members purchasing more expensive brand-name drugs as opposed to the cheaper generics.

Nancy Smith-Leslie, Medicaid director for the Human Services Department, told the panel that Medicaid members currently use about 80 percent generic and 20 percent brand-name drugs.

Potter, of Blue Cross Blue Shield, made the proposal. She said other state Medicaid programs have higher rates of generic drug use.

“There’s an enormous opportunity to reduce costs,” Potter said.

Abuko Estrada, staff attorney for the New Mexico Center on Law and Poverty, urged the panel to vote against the recommendation because of a lack of data about its impact. He said the department should look for other ways to find Medicaid savings beyond cutting the benefits package.

The recommendation passed on a 5-3 vote.

Justin Horwath can be reached at 505-986-3017 or jhorwath@sfnewmexican.com.