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New Mexico Tribes Argue State Did Not Adequately Consult Them About Medicaid Changes

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New Mexico has proposed a redesign of its Medicaid program, which currently covers 1 in 4 state residents, including many American Indians, reported

The changes would potentially allow New Mexico's 22 tribes to assume greater control of how Medicaid services are delivered to Tribal members. For instance, Gov. Susana Martinez's administration is considering making "mini block grants" available to Indian communities for pilot projects, according to a May 22 letter sent to providers.

But Tribal officials clashed with state authorities Monday over the lack of consultation with the Navajo Nation, New Mexico's two Apache tribes and its 19 pueblos.

Human services secretary, Sidonie Squier, acknowledged her agency's letter announcing the meeting to health care providers serving the state's tribal populations arrived later than the required advance notice of 60 days.

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Nonethless, Squier told state lawmakers that communication and coordination was good. "This is about getting a not-healthy population healthier," she said. "The question is: 'Where does that fit in my priorities?' And that is way up there."

Tribal representatives also argued that the plan fails to recognize the challenges of delivering care on rural pueblos and reservations.

"I am very offended that they [the New Mexico Human Services Department] still do not understand tribes," Joshua Madalena, governor of Jemez Pueblo, told state lawmakers. "Each tribe is different. Each tribe will sit here and tell you a different story" on how to care for its members.