- Joanne Green
 

The Great Sphynx of Egypt has, over the years,
Lost her nose.
Venus de Milo has no arms,
And the Liberty Bell sports a great, wide crack.
And yet each of these is considered to be a thing of beauty,
A standard of perfection.
And so it must be that we do not,
as one might imagine,
Look to perfection in order to see beauty,
But rather, we look to beauty,
And thereby see perfection.

by Jim Copeland

As I am writing this, the Special Session is over.  The purpose of the Special Session was to eliminate the shortfall for Fiscal Year 2009 and balance the budget for Fiscal Year 2010.  There were several bills sent to the Governor for his consideration.  He has until November 12, 2009 to sign, veto, or partially veto the legislation.

Where does that leave Alta Mira?  The short answer is we don’t know until the Governor has acted on the legislation.  The legislation he received had a $16 million reduction in Medicaid.  The reduction was made up with other state and federal funding.  If the Governor vetoes all or part of the legislation, that could increase the amount of money to be reduced in Medicaid.  There may not be sufficient money to cover an increased reduction. 

What does that mean to Alta Mira?  The short answer is, at this time, we don’t know.  It would depend on the implementation of any other legislation or budget reductions in Medicaid. 

When will we know?  The short answer is we may not know for sure until the regular session of the legislature is over in February.  I would like to say that Alta Mira will not be impacted at all.  I don’t think that will be the case.  I don’t want to become the Executive Director of “doom and gloom”, but I also don’t want to be Pollyanna. 

There is a serious budget deficit in state government in New Mexico.  The easiest way to fix that deficit is to reduce spending.  Any state government spends the majority of its money on providing services to the citizens of the state.  When spending has to be reduced, it is generally services to the citizens that bear the brunt of the reductions.  There are other ways to fix budget deficits.  The usual one is to increase taxes.  There are numerous theories on the pros and cons for increasing taxes.  But, once again, the burden of the solution falls on the citizens of the state.

The Management Team and the Board of Directors will be reviewing potential adjustments to the possible revenue reductions.  I have misplaced my crystal ball so I don’t have a clear view of the future.  I do know the longer we wait for an answer to the questions, the shorter amount of time we have to adjust Alta Mira expenditures.  I also know that the Alta Mira families, providers, contractors, employees, and Board members will continue to make decisions based on sound information. 

I don’t believe that it will be painless.  I think everyone will share in the pain.  I believe that the organization will come out the other side stronger and more resilient.  As always, if you have questions, comments, or a crystal ball, please feel free to contact me.  I may be reached by e-mail at jcopeland@AltaMiraNM.org or by direct telephone line at 366-2117.          
 

by Jim Copeland

It seems like every time I am asked to write something, there is some sort of crisis.  This month is no exception.  There are a number of things taking place right now that are somewhat stress producing.  There is the state budget shortfall and all the associated press related to it.  There is the projected Medicaid budget deficit and the laundry list of issues related to cost containment.  There is the upcoming Developmental Disabilities Waiver re-write.  Each of these things by themselves are enough to cause at least a rapid heart rate.  But, when you add them all together, they are enough to cause, at least for me, heart attack or stroke related symptoms.

In a recent public meeting, the Developmental Disabilities Supports Division (DDSD) reported that the DD Waiver has to change.  This need is due to increasing demand and limited resources.  The system needs to increase the overall cost effectiveness and maximize the impact of available funds while maintaining person centered services.  The average cost of supporting someone on the waiver for Fiscal Year 2009 was $73,500.  The projection for Fiscal Year 2010 is $75,300.  The average cost for eight other states with similar waiver programs ranged from $14,500 to $58,500 per person.

82% of all individuals on the DD Waiver are receiving a residential service.  The cost of those services accounted for 66% of the total cost of the Waiver expenditures in Fiscal Year 2008.  The purpose of the waiver is to prevent the need for institutional care and lead to greater independence from paid supports, to provide meaningful social integration, and promote the development of daily living skills essential to a successful, inclusive life in the community.

While almost 4000 individuals are currently receiving supports, there are more than 4,650 waiting for supports.  The wait for services currently exceeds 7 years.  The waiver is designed to be a lifespan program.  The current service package is focused primarily on adults.  It is reported that the majority of the 4,650 waiting for services are children under the age of 18. 

We need to prepare for some changes.  The changes that will be implemented will be effective July 1, 2010.  Now is the time to have your voice heard.  Please give your input to your Service Coordinator, to the DDSD staff, to the Human Services Department, or your elected representatives.

Change is coming.  Without your input, you leave yourself open to the whims of the system.  Even with your input, you will be open to the whims of the system, but at least you will have had your say.  If you have questions, please feel free to contact me.  I may be reached at 366-2117 or by e-mail at jcopeland@altamiranm.org. 

Thanks for your continued support and interest in Alta Mira. 

by Jim Copeland

Well, it is that time of year when most agencies are going through the stress that is known as budget preparation.  It is not a pretty sight.  You look at every dollar that is spent.  Where was it spent?  What was it spent for?  Do we have to spend that dollar again this year?  The answer to that last question is usually yes, but it’s $1.25 this year.  Then the question becomes, where are we going to get the $1.25 this year?

What most people may or may not know is that the money for the most part, at least for Alta Mira, comes from contracts/provider agreements with the Department of Health.  Also, another concern is the Department of Health doesn’t include cost of living adjustments in those agreements.  What does that mean?  It is just like your own family budget.  The cost of living; groceries, gas, utilities, insurance, property taxes, clothing, and anything else you purchase or have to have goes up, but your salary stays the same.  How do you handle those situations?  Credit cards society has painfully discovered are not the first solution.  At some point, you have to pay the piper.  The first thing you do is look at where you can reduce your spending.

In our case, the fixed costs cannot be reduced.  Workers Compensation, unemployment, property, liability and health insurance, and utilities, etc. are fixed.  (Well, actually they aren’t fixed.  They seem to go up every year.)  Because Alta Mira is primarily a service provider, we have to employ the people to provide the services.  That is where we spend approximately 85 – 90% of our budget.  To reduce spending, means to reduce what we pay or the benefits we provide to our employees.  Neither of those options seems viable at this time.  Those options would most likely have one impact.  They would create turnover.  Turnover disrupts the services that families receive at critical times in their lives.  One other option is to secure the funding needed through grants, fund raisers, gifts, bequests, or in-kind support.

We are pursuing the fund-raising options.  Monday, August 10, Alta Mira is scheduled to have its first Alta Mira golf classic.  Vicki Assaad, the Alta Mira Board of Directors, and the entire Alta Mira staff are working to secure donations and support for this effort. 
We are pursuing the grants options.  We are receiving funding from the United Way, the Governor’s Commission on Disability, and other foundations and individuals.  We have submitted applications to funding sources to seek additional support for the valuable programs that Alta Mira provides.  We are also looking at expanding our services to see if we can diversify our income streams.

Well, enough of hearing about our problems.  You probably have problems of your own.  But, if one of your problems is what to do with all that excess money, I think I may be able to offer some advice.  If you could see yourself helping to support a family who is struggling with a family member with a developmental disability or delay, we might be just the right fit for you.  If you are interested in assisting us in any of these efforts, please contact Vicki Assaad, (505) 366-2132 or me (505) 366-2117. 

• Waiting to see what legislation the Governor will sign and what he won’t sign.
• Waiting to see what the Budget looks like for next year
• Waiting to see what the Stimulus money will be used for
• Waiting to see if the “Waiting” list is reduced
• Waiting to see if “good things REALLY come to those who wait”

by Jim Copeland

The Legislative Session ends on March 21, 2009 at noon.  What will be the outcome?  Has anyone found the crystal ball that would tell us what is going to occur?  I have been to the Roundhouse several times this session.  I have spoken with legislators about the current situation.  As the session continues, it is amazing to me the attitude of those elected to represent us.  They continue to show up for work in what has got to be the most difficult of times in recent memory.  They continue to want to hear from the folks back home.  (It might be more the “misery loves company” adage than anything else.)

I am continually impressed with the overall compassion and caring that these men and women show for all the citizens of New Mexico, not just their constituents.  Times are tough.  People are hurting, homeless, and hungry.  The legislature knows there is little money, but they keep showing up for work.  They keep listening to people, lobbyists, organizations, and everyone else asking for help, support, or assistance with each and every one of the needs.

Believe it or not, there are situations more pressing than those of the families that Alta Mira supports.  There are situations that have the potential to impact the very world we live in.  The environment that we will leave to our children and grandchildren is being constructed with today’s financial crisis.  The infrastructure; streets, highways, and schools are being impacted by the current economic situation. 

I have stated before that the current system of services to the families Alta Mira supports is not sustainable.  Revisions are going to be necessary to all services.  It is my hope that Alta Mira can take a lead role in the input into what those revisions will look like.  We see the service delivery system from a unique perspective.  Alta Mira provides supports in all of the program areas for people with developmental disabilities.  We provide early intervention (Family Infant Toddler – FIT), developmental disability waiver, and state general fund services.  Our staff have a composite view of the needs of people we serve in the Albuquerque metro region. 

There will be changes coming to these programs.  It is incumbent on all of us, people receiving services, people on the waiting list, and people who aren’t even born yet who will need these services, to develop a service delivery model that will be sustainable.  We are looking at developing sustainable energy, green buildings and jobs, and reducing global warming all toward the idea of being around for years to come.  We should do no less for services for people with developmental disabilities. 

If you have questions or concerns, please feel free to contact me.  I may be reached by direct phone line at 366-2117 or by e-mail at jcopeland@altamiranm.org.

by Jim Copeland

I have heard the Human Services Department has determined the $10 million appropriation from the Special Session will be used to serve people on the DD Waiver Waiting List.  $9 million is going for services.  $1 million is going to the Developmental Disabilities Supports Division in the Department of Health for infrastructure development.  This is the latest information I have been able to determine.  There is supposed to be a press release from the Human Services Department, but I have not seen it as of the writing of this piece.

I have also heard the $10 million may not be available when the legislature meets in January.  The price of a gallon of gasoline has dropped significantly over the past month.  That is good news for those of us who drive.  It could be terrible news for those citizens of New Mexico who are waiting for services.  The New Mexico economy is based significantly on the price of oil and gas.  With the drop in the price of gasoline there is a significant drop in the expected revenue for state coffers.  This revised revenue projection caused the Governor to mandate reductions in state expenditures throughout state government. 

How will this ultimately effect the $10 million appropriation?  We won’t be sure until the legislative session is over in March.  Who will be impacted?  We won’t know until the allocations have been made (or not made).  When will the price of gasoline go back up?  We only know that it WILL go back up.  It is difficult to need things to happen and know the consequences both if they do happen and if they don’t happen.  In general, people need cheap gasoline to get to and from their jobs and other responsibilities.  In particular, people on the DD Wavier waiting list need more expensive gasoline so they can get to their lives.  Never have there been more divergent needs on the same coin (or dollar).

Tune in next month to see where we are, what we know, and how it will probably impact all of us.   

by Jim Copeland
The Advisory Council on Quality, or ACQ, advises the state on matters of importance in the area of developmental disability in NM, and our most recent meeting was last week.  Here are a few statistics revealed at last week’s meeting:

There are currently 4,380 people on the Central Registry Waiting List for DD Waiver services.  This does not include individuals who are in the “pending” category.  (“Pending” is for folks who, for whatever reason, haven’t established eligibility.  Usually, it is for the functional piece of eligibility.)  Last fiscal year, there were 3,776 people receiving services at a total cost of $267,000,000.  That is an average per year cost of $70,709 per person.  There are currently more people on the waiting list than are being served. 

The next allocations for the Metro Region will be for people who were put on the Registry as of May 30, 2001.  That’s already more than a 7 year wait for services.  Seven years.  It gets worse when you consider the following:  New Mexico allocates approximately 150 people per year.  Let’s see, 4,380 divided by 150 =29.2.  Twenty-nine point two.  That’s the number of years a person who was placed on the Registry on October 1, 2008 is likely to have to wait before receiving services. 

You can draw your own conclusions, but for all of us at the ACQ meeting, the numbers made one thing crystal clear:  We have a system we can’t sustain.  The chore is to figure out how we reduce costs without a perceived reduction in services.  Anyone know any really good magicians?
 

by Jim Copeland

It is becoming more difficult to determine what is actually going to happen and this isn’t even going to be about politics.  There has been much press about the special legislative session and the $10 million appropriation.  Emotions are running pretty high.  People are making plans for what services they will receive when they get allocated to the DD Waiver from the waiting list.  In most cases these families have been waiting for at least 3 or 4 years.  These families have been struggling with the demands of providing supports for an individual with developmental disabilities for a much longer period of time.

At a recent meeting with Department of Health personnel, I was informed that there has been no final decision as to the $10 million and how it is going to be expended.  That doesn’t mean that the money will not ultimately be used to allocate people from the waiting list.  It just means to me that no decision has been made.  This is contrary to the majority of opinions that have surfaced on the internet and in coffee shop conversations.  As they say in the south, I don’t have a dog in this fight.  But, I do have feeling that it is absolutely necessary that people receive accurate information.  When you have been living your life with the stress and pressure of having to make arrangements for the care and support of a family member with a disability you begin to look for any sign that help is on the way.

Alta Mira has been that help since 1985.  Albuquerque Special Preschool and Esperanza Para Nuestros Niños were that help prior to that.  We have seen and been involved with lots of stories about that needed help and the impact it made in the lives of families.  We are continually looking for new ways to provide the help to more families.  If you have suggestions about how we might be of help, please feel free to contact me.  If you want to become involved in helping us help others, I would love to talk with you.  I may be reached by e-mail at jcopeland@altamiranm.org or by direct telephone at (505) 366-2117.