If New Mexico uses federal Medicaid dollars to help pay for home visiting, the state could expand the program to reach more children.
Elizabeth Groginsky, Early Childhood Education and Care Department secretary, said during an interim Health and Human Services Committee hearing on Monday that the goal is to grow the program and with the help of leveraging federal Medicaid dollars, it could do so.
Groginsky and Kelly Klundt, a Legislative Finance Committee analyst, presented before the HHSC to talk about the need to leverage federal Medicaid dollars. The LFC “Legistat” report says that Medicaid currently covers more than 70 percent of all births in New Mexico. This represents a large proportion of families who could also be eligible for the state’s home visiting program.
Klundt said that through home visiting, a paraprofessional or professional comes to the home, screens for the families’ needs and can provide things such as lactation support, behavioral health support and ensure developmental milestones. She said that if more families in New Mexico were enrolled in home visiting programs and completed them successfully, there would be fewer children in crisis on Children, Families and Youth Department caseloads.
Currently, the state has allocated $28.5 million from general fund revenues for the home visiting program. There are several home visiting models utilized around the state, but the essential idea is for professional or paraprofessional providers to come to the home and identify areas the needs in the home and help improve parenting and reduce child maltreatment.
But, even as providers report waiting lists for the services, the Legistat report says that only about 7 percent of home visiting families completed the program in Fiscal Year 2023.
But, there are some challenges to shifting home visiting providers to charge federal Medicaid dollars for the work. There is a burdensome credentialing process for providers and federal Medicaid can be slow to pay and can also deny payment, causing the provider to have to resubmit payments, Groginsky said.
She said the department has also not stressed that providers move to federal Medicaid reimbursement but that is changing. For every $1 the state spends on home visiting, federal Medicaid matches those funds with $3.45, Klundt said.
“If we could implement these [home visiting] programs to fidelity and target families, we would reduce child maltreatment by 3 to 5 percent,” Klundt said.
Several legislators asked about the credentialing process and said they want the state to improve the burden for that.
State Rep. Pamelya Herndon, D-Albuquerque, asked if home visiting is improved, if it would also help with the infant mortality and maternal mortality rates in the state, which are higher than average.
Klundt said that while home visiting doesn’t reduce those issues, Medicaid is now covering doulas and their presence leads to reductions in cesarean section births, emergency room visits and improved birth weight.
“Home visiting is more of an early development family model. Those two should be working together. We have a lot of poverty and deserts of care in our state. It’s a complicated issue. DOH is the centralized focus on those pieces,” she said.