Continued Underpayment for Care of Developmentally Disabled Leads to 33.9% Increase in Abuse and Neglect

Lack of Workforce Once Again Strikes Waiver Needs

(This reporting originally appeared in The Candle.)

On March 9, 2022, Governor Michelle Lujan Grisham issued a press release stating she, “signed the state budget for Fiscal Year 2023, making record investments in education, public safety, quality of life improvements … Highlights of the enacted budget include: $18 million to eliminate the developmental disabilities waiver waitlist and increase provider rates…”

But after two years, despite all the hype about eliminating the waiting list, many clients of the Developmental Disabilities Waiver continue to be under-served due to a lack of sufficient funding and planning for the addition of thousands more into programs that were already stretched thin.

The Wait List morphed from one where thousands of people were waiting to get on the approved list for Waiver services, to a list of people denied services because there aren’t enough care givers.

And that failure to adequately plan and fund has led to increases of abuse, neglect and exploitation – some so abusive that it ends in death, as in the matter of Mary Melero.

Legislators Question Administration’s Claim of Elimination of Wait List

Now, two years after the Governor’s election year announcement that she was eliminating the Waiver Waitlist, legislators are asking why disabled people in need are still not getting services.

At the May 7, 2024, meeting of the Legislative Health and Human Services Committee, the Chairman, Senator Gerald Ortiz y Pino, wanted an update on the Wait List.

“Is the waiting list for Developmentally Disabled Waiver programs gone, or what’s the status of it – is there still one?” queried Ortiz y Pino of the Committee’s staff.

A senior analyst responded, “Yeah, my understanding [from the administration] is it’s pretty much been worked through, although there are still some folks that might have been offered the Waiver and they were holding off for the moment, and the department is kind of working back through some of that.”

But Representative Liz Thomson, herself the mother of a son with developmental disabilities, was not going to let the administration’s assertions go unchallenged.

Thomson, the Committee’s Vice Chair, immediately expressed frustration that while the waiver wait list may have disappeared on paper, in reality people were still not receiving services.

“Mr. Chair, … there aren’t services available. You may get a spot on the Waiver, but if there’s no PT [physical therapists – for example] to provide the service, you’re not on the Wait list, but you’re also not getting services. Workforce, once again strikes,” countered Thomson.

The Vice Chair’s appraisal reflects the frustration of many Developmental Disabilities Waiver clients, their families, and guardians of clients.

In the last two years, more providers of services have been turning down new clients due to the inability to retain and recruit sufficient staff to provide safe care.

The Candle has spent a year investigating the causes for inadequate delivery of care and protection of Developmentally Disabled New Mexicans.

The research included reviewing scores of agency documents and communications (mostly received from responses to Inspection of Public Records Act requests), and interviews with care givers, family members of Waiver clients, and inside sources at state agencies.

The Candle has been able to identify that, at the core, retention and recruitment of a properly trained workforce, commensurate with the needs of the Developmentally Disabled, is directly related to the compensation provided by state – which in turn lessens the amount of federal funds received to help and protect this vulnerable population.

Not having sufficient numbers of properly trained and focused staff can, and does, lead to increased exposure of clients to abuse, neglect and exploitation.

If this appears plainly logical, it is – just ask the real stakeholders of the Waiver.

Unfortunately, policy makers through many administrations and multiple sessions of convening legislatures, have produced insufficient budgets and focused their management more on sweeping problems under the rug, instead of getting them solved.

The Governor’s announcement of the elimination of the wait list in April of 2022, was an election year gimmick – not a policy advancement.

A campaign’s slight of hand attempting to cover up the indifference the administration demonstrated by four years of inadequate budgets and staffing allotments, and having no realistic plan in place to grow the workforce to accommodate the increase of participants.

While it is notable that, despite all of the challenges the state faced during the COVID epidemic, New Mexico state government was awash in additional revenue – billions of additional dollars – some from the federal government’s response to COVID, and several billion in increased revenues from state sources such as increased oil and gas royalties and GRT.

Yet, the administration made no serious budget and policy attempt to insure the elimination of the paper Wait List resulted in addressing the actual needs of the people who were on that Wait List for years.

The administration’s policy and funding decisions had serious consequences.

Political indifference can, and usually does, lead to severe and extremely regrettable results – in this instance the abuse of already incredibly vulnerable people.

Proof of the abuse comes from the very agencies the Governor runs and the legislature funds.

“Between June of 2022 and June of 2023, there was a 33.9% increase in individuals determined to have been victims of abuse, neglect, or exploitation.” – New Mexico Division of Health Improvement 2023 Annual Report.

Looking closely at the most recent annual report of the New Mexico agency in charge of protecting intellectually and developmentally disabled New Mexicans, it is obvious that abuse, neglect and exploitation are getting worse.

In March of 2023, not even a year after announcing the end of the Waiver Wait List, Governor Michelle Lujan Grisham held a press conference, acknowledging the “horrific” abuse and neglect of a client supposedly in the care of the state.

Mary Melero’s death a little over a month after the revelation of her horrific abuse, came after years of failure by the administrations of both Governor Lujan Grisham and her predecessor, Susana Martinez, to protect her.

In a press release regarding the abuse of Mary Melero, the Governor and her staff claimed that her administration is “using every tool at our disposal to protect these vulnerable individuals and to make sure that incidents of abuse, neglect, and exploitation do not happen ever again in our state.”

A review of the numbers in the table below reveals the unvarnished truth: the state needs better tools and better leadership.

The Candle will be publishing a detailed report next week on the nexus of inadequate compensation, retention and recruitment, and how that leads to increased inability to guard against abuse, neglect and exploitation.