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Updated @9 a.m. — Human Services Department (HSD) Cabinet Secretary Sedonie Squire has rejected a call by more than a dozen health advocacy organizations to create a public Medicaid Redesign Task Force, and to include Medicaid providers, patients and lawmakers in the state’s Medicaid overhaul process.

“As you know, we selected Alicia Smith and Associates to help us lead this redesign and modernization effort,” Squier wrote in a June 1 letter to the New Mexico Medicaid Coalition.

Squier did not address concerns about HSD’s failure to involve Indian tribes in the Medicaid overhaul process, a possible violation of state law. But HSD spokesman Matt Kennicott said Thursday those concerns are “unfounded” and that a “tribal consultation meeting” will be scheduled.

“There may be opportunities to create targeted taskforces or working groups for specific elements of the modernization project, but, at this time, I do not plan to create a Medicaid Redesign Taskforce, as you requested,” Squier wrote. “Nevertheless, we are committed to ensuring the Medicaid program provides the best care possible, and please be assured we will be listening directly to the voices of those you represent.”

Squier’s letter responded to a May 13 letter from the Coalition, a group of 13 organizations, including the N.M. Center on Law and Poverty, N.M. Voices for Children, ARC,  the Disability Coalition, Pediatric Society, Health Action New Mexico and the N.M. Indian Council on Aging.

The Coalition’s letter voiced concern about the secrecy of HSD’s Medicaid redesign effort, noting that other states, including Kansas, Montana, New York, and Oregon, are including lawmakers and the public in their own Medicaid redesign efforts.

“New Mexico should follow this approach,” the Coalition letter states:

HSD’s choice to employ the confidential procurement process to analyze and redesign a program that directly or indirectly affects virtually every New Mexican is not an appropriate way to make public policy. Only a truly participatory process that gives a meaningful role to Medicaid clients, stakeholders, the general public, and the Legislature will provide the expertise and skills required for the successful evolution of the program. To date, as the Department has moved forward with Medicaid redesign, you have not sought the input of the public, advocates, providers, or the legislature. At a meeting held with members of your Department and several Medicaid Coalition members on April 29th, Acting Director Weinberg refused to discuss any details regarding the process to date or to commit to what direction the redesign will take, but she assured us that stakeholder and public input will be sought as changes to the program are considered.

State law requires Indian tribe involvement in the overhaul

A failure to consult Native Americans on the process would violate the state’s Tribal Collaboration Act, the Coaltion letter also notes.

The law requires state agencies to make a “reasonable effort to collaborate” with Native Americans on policies affecting Native American populations.

“While many Native Americans are currently on Medicaid, and many more will soon be eligible under health care reform, the Department has failed to consult with Native Americans about the redesign proposal,” the Coalition letter states. “Decisions that impact so many people in such fundamental ways cannot and should not be made behind closed doors.”

Squier’s letter did not address the Coalition’s concern about tribal involvement in the Medicaid overhaul. But in an e-mail to Veritas NM Thursday morning,  Kennicott said:

The concern that the tribes are not being consulted on the Medicaid modernization process is unfounded. We are still in the very early stages of the process and are developing a schedule of stakeholder meetings and public input sessions, including a specific tribal consultation meeting. We look forward to working with all stakeholders throughout the entire process to bring a modern, sustainable Medicaid program to New Mexico to continue providing services for those most in need among us.

Coalition members are disappointed by Squier’s response, Health Action New Mexico and N.M. Voices for Children’s Bill Jordan told Veritas New Mexico.

HSD awarded Washington, D.C.-based Alicia Smith & Associates a $1.5 million contract to redesign the state’s troubled $3.9 billion Medicaid health insurance program for people with disabilities and low income, and the children of parents with low income. Reforms sought by the state will include unspecified eligibility changes.

Rushed, secretive contracting criticized

The selection of the firm was criticized by some lawmakers as rushed and secretive. Lawmakers are “completely in the dark,” Sen. Dede Feldman (D-Albuquerque) told Veritas NM.

HSD accepted proposals for the Medicaid Redesign contract for only a month, between March 14 to April 14.  Alicia Smith & Associates’ proposal beat out three other companies, but that had nothing to do with Alicia Smith’s having hired former HSD cabinet secretary Kathryn “Katie” Falls as a consultant in December 2010, before Falls left the HSD, HSD spokeswoman Betina McCracken has said.

Falls was hired by Alicia Smith & Associates just weeks after she signed the latest of a string of no-bid HSD consulting contracts with the company, late last year.

Falls was not involved in helping her new employer prepare the winning Medicaid redesign proposal, McCracken told Veritas NM. But Alicia Smith herself has failed to respond to requests for comment on whether or not Falls was involved in the proposal’s preparation.