Alic e B rian L iu B lalo c k M c Coy Children, Youth, & Families Aging and Long-Term Department Services Department New M Mexic xico H Healt ealth C Cabinet Secr t Secretarie ies . Working Together for N ew Mexicans David Kathy S c ras e, M . D. Ku n kel Department of Health Human Services Department Legislative Health and Human Services Committee, July 24-25, 2019
AGENDA ▪ Current Status of the Human Services Department (HSD) ▪ HSD Strategic Plan ▪ Key HSD issues that may need to be addressed in the next several Legislative sessions 2
CURRENT STATUS OF AGENCY ▪ Introduction to Healthcare Team ▪ HSD Programs and Numbers Served ▪ Travels around the State ▪ 6-month diagnoses from new administration on agency: key issues that need to be addressed immediately, in short term, long term 3
GOVERNOR MICHELLE LUJAN GRISHAM Secretary Brian Blalock Secretary David Scrase, M.D. Secretary Kathy Kunkel Secretary Alice Liu McCoy Children, Youth and Families Human Services Department Department of Health Department of Aging and Department Long-Term Services 4
OFFICE OF THE GOVERNOR STAFF Jane Wishner Teresa Casados Mariana Padilla Executive Policy Advisor Chief Operating Officer Children’s Cabinet Director for Health and Human Services 5
FY20 New Mexicans FY20 Budget Budget Served as of June General Fund % of GF GF + Fed % of Total Program 2019 (GF, 000) Budget (000) Budget Medicaid (managed + FFS) 824,888 985,537.4 88.70% 5,949,158.8 83.27% SNAP 446,216 0.0 0.00% 660,000.0 9.24% TANF 28,037 87.0 0.01% 140,049.9 1.96% CSED 214,603 7,927.1 0.71% 31,871.1 0.45% Other Programs 212,230 117,523.2 10.58% 363,576.3 5.09% TOTAL *948,479 1,111,074.7 100.00% 7,144,656.1 100.00% *Total Unduplicated Recipients 6
HSD LEADERSHIP FIELD OFFICE TOUR 2019 April 16, Taos April 23, Bernalillo: CASA, ABQ: FANS, CSED Albuquerque North and South April 29- May 1, Moriarty, Tucumcari, Clovis, Hobbs, Carlsbad, Artesia, Roswell, Ruidoso, Alamogordo, Los Lunas May 28 - 30, T or C, Anthony, Las Cruces, Deming, Silver City, Socorro June 12 & 13, Rio Rancho, Farmington, Gallup, Grants June 28, Las Vegas, Espanola July 2, Santa Fe July 16, Albuquerque ISD offices 7
6-MONTH DIAGNOSES FOR HSD FROM THE NEW ADMINISTRATION: KEY ISSUES THAT NEED TO BE ADDRESSED LONG TERM (2-4 YEARS) IMMEDIATE SHORT TERM (1 -2 YEARS) Employee training Employee retention and career • • Employee morale • development Implement most of HHS 2020 and • • Develop leadership team develop analytic capabilities Finalize HHS 2020 with high • degree of interoperability with Behavioral health and primary • other Departments • Rebuild the public trust in HSD care provider network (including rates) • Long term provider payment • New approach to child support and system (benchmarked, fair, new information system Medicaid provider payment • adjustable to inflation and State rates revenue) • Resolve major lawsuits and sanctions • Approach to sanctions and DD supports waiver • Indigenous managed care entity • lawsuits implementation Plans to expand insurance coverage • • HHS 2020 back on track • New Child Support information system DD supports waiver development • ASPEN modifications • DD supports waiver planning • 8
HSD MISSION AND GOALS MISSION: Working with our partners, we design and deliver innovative, high quality health and human services that improve security and promote independence for New Mexicans in their communities. GOALS: 1. Improve the value and range of services we provide to ensure that every qualified New Mexican receives timely and accurate benefits. 2. Create effective, transparent communication to enhance the public trust. 3. Successfully implement technology to give customers and staff the best and most convenient access to services and information. 4. Promote an environment of mutual respect, trust and open communication for staff to grow and reach their professional goals. 9
HSD SD GOAL 1 1: I : IMPROVE TH THE V VALUE A AND R RANGE O OF SE F SERVICES WE P PROVIDE T E TO E ENSURE RE T THA HAT E EVER ERY QU QUALI LIFIED N NEW MEXICAN R RECEI EIVES T TIMEL ELY A Y AND A ACCURATE B E BEN ENEF EFITS. 1. Ensure that every qualified New Mexicans receives timely and accurate benefits 2. Expand the BH network to provide a full continuum of behavioral health services 3. Implement long-term cost sustainable provider payment strategy (benchmarked, annual inflation adjustment, annual adjustment for state revenue) to expand the provider network 4. Develop and implement plan for IMCE (Indigenous Managed Care Entity) 5. Develop plan to enhance recruiting and retention for BH, PCP, rural 6. Increase insurance options for the currently uninsured and those with unaffordable plans 7. Expand value based purchasing to focus on measurable health outcome improvements 8. Modernize child support program to improve the financial and medical support of New Mexico’s children. 9. Support DOH in development of DD waiver revisions (including supports waiver) 10
HS HSD D GOAL 2 2: CREATE TE E EFFECTI TIVE, E, T TRANSP SPARE RENT T COMMUN UNICATION ON T TO ENHAN ANCE T THE P PUBLIC T TRUST. 1. Develop and implement a comprehensive external communication plan 2. Implement a department wide strategy to include partners (federal, state and local, tribes, community-based services, providers, advocates, MCOs) in decisions that affect them. 3. Resolve major ongoing litigation and sanctions: Debra Hatten-Gonzales (31 years), Behavioral Health, Food and Nutrition Services sanction 11
HSD GOAL 3 L 3: S SUC UCCESSFULL LLY I Y IMPLEMEN ENT T TECHNOLOGY T Y TO GIVE E CUS USTOMER ERS A AND S STAFF THE B E BEST A AND M MOST CONVE NVENIENT NT A ACCESS T TO S SERVI VICES A AND I INF NFOR ORMATION ON 1. Implement HHS 2020 modules: system integration (SI), data services (DS), quality assurance (QA), financial services (FS), benefit management services (BMS), unified public interface (UPI) 2. Implement business transformation to redesign, streamline and improve our processes 3. Provide greater access to timely enterprise data to enhance evidence-based decision making 4. Expand and improve automation and self service capabilities for ease of access to services 5. Identify replacement strategy for Child Support Information System (only one of two applications on mainframe, programming language obsolete) 12
HSD GO GOAL 4 4: P PROMOTE A AN ENVI VIRONMENT OF OF M MUTUAL RESPE PECT, T TRUST A AND ND O OPEN COMMUNICA CATION F FOR STAFF TO G GROW A AND R REACH H THEI EIR P PROFESSIONAL G L GOALS LS. 1. Develop and implement comprehensive internal communication plan 2. Develop and implement comprehensive department-wide employee training program 3. Develop and implement a comprehensive department-wide management training and succession planning program 4. Improve employee satisfaction 13
BEHAVIOR ORAL AL H HEAL ALTH C COLLAB ABOR ORATIVE ( (BHC) GOALS 1) Expansion of Behavioral Health Provider Network 2) Expansion of Community Based Mental Health Services for Children 3) Effectively Address Substance Use Disorder (SUD) 4) Provide Effective Behavioral Health Services for Justice-Involved Individuals 14
BHC GOAL 1: EXPANSION OF BEHAVIORAL HEALTH PROVIDER NETWORK ▪ There is a significant problem with access to Behavioral Services in the state for Medicaid members ▪ Estimates suggest that only one- third of BH providers take Medicaid patients ▪ The incidence of BH issues is higher in the Medicaid population ▪ Benchmarks are difficult to obtain, current reports inadequate 15
NEW MEXICO HEALTH CARE WORKFORCE COMMITTEE REPORT, 2018 16
INTERVENTIONS TO EXPAND BEHAVIORAL HEALTH PROVIDER NETWORK Top 30 BH Outpatient Proc Codes 90837 PSYTX PT&/FAMILY 60 MINUTES H0020 ALCOHOL AND/OR DRUG SERVICES; METHADONE S5145 FOSTER CARE THERAPEUTIC, PER DIEM 1. Expand potential new services by $34 M 90834 PSYTX PT&/FAMILY 45 MINUTES (7/2018, 1/2019) 90847 FAMILY PSYTX W/PT 50 MIN H0015 ALCOHOL AND/OR DRUG SERVICES; INTENSIVE H2033 MULTISYSTEMIC THERAPY FOR JUVENILES, PER 2. Expand base payment rates for E&M codes 90791 PSYCH DIAGNOSTIC EVALUATION (7/2019) and expanded BH services H2015 COMP COMM SUPP SVC, 15 MIN H2017 PSYSOC REHAB SVC, PER 15 MIN (10/2019) ► 90853 GROUP PSYCHOTHERAPY (OTHER THAN OF A MUL H2015 COMP COMM SUPP SVC, 15 MIN 3. Address ongoing administrative appeals 90832 PSYTX PT&/FAMILY 30 MINUTES 0365T ADAPTIVE BEHAVIOR TX ADDL and lawsuits T1026 PED COMPR CARE PKG, PER HOUR 0365T ADAPTIVE BEHAVIOR TX ADDL ▪ Update on settlements H2012 BEHAV HLTH DAY TREAT, PER HR H2014 SKILLS TRAIN AND DEV, 15 MIN 4. Work with DOH, DHE, DWS and UNM to S5145 FOSTER CARE THERAPEUTIC, PER DIEM G9001 COORDINATED CARE FEE, INITIAL RATE grow our own BH workforce 90846 FAMILY PSYTX W/O PT 50 MIN H0039 ASSER COM TX FACE-FACE/15MIN 5. Identify new opportunities to expand loan 80307 DRUG TEST PRSMV CHEM ANLYZR 90863 PHARMACOLOGIC MGMT W/PSYTX forgiveness 90792 PSYCH DIAG EVAL W/MED SRVCS 17
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