NM center on law and poverty
 

Comments on Transportation Services

May 10, 2004

Pamela Hyde, Secretary, JD

Human Services Department

P.O. Box 2348

Santa Fe, NM 87504

Re: Comments to proposed regulations contained in Human Services Register Volume 27 #10

SENT VIA FACSIMILE AND US MAIL

Dear Secretary Hyde:

     The Center on Law and Poverty is submitting its comments to the proposed regulations contained in the above referenced Human Services Register.  We oppose the Department’s proposal to discontinue providing clients with transportation to pharmacies. (See MAD 756.4)  We feel the decision will contribute to the inability of client’s to obtain needed health care and is fiscally irresponsible.  If the Human Services Department plans to apply this regulation to children, it may also violate federal law.

     It is critical that individuals needing medication have access to it.  The Department’s proposed regulation will hinder such access.  Many New Mexicans live in areas where there is not an adequate transportation system.  Some of these same individuals do not own working vehicles.  Therefore, if they cannot obtain needed transportation assisted from the state they may be forced to do without needed medications.  This will place their health in jeopardy.  If their health deteriorates greatly they will end up seeking care in emergency rooms which may cost the state more money than it would spend on transporting them to pharmacies. 

     It is my understanding that the state is planning to develop a mail order system to avoid the aforementioned problems.  Under this system individuals without transportation could have needed medicines delivered to their homes.   At the very least, the Center on Law and Poverty proposes that the states continue to provide transportation until this system is fully implemented.  Even a fully operating mail order system will not be of help to individuals who are in acute crisis and need medication that as not been prescribed to them previously.  We would propose that the state revise the regulation to assure that individuals in this predicament have access to needed transportation and therefore needed medications.   

     Federal Law requires that states provide transportation to children.  See 42 CFR § 440.17  This regulation was promulgated as part of a requirement that the state provide services to children when the services are needed to “correct or ameliorate” a condition whether or not such services are provided in the state Medicaid program.   See 42 U.S.C. §§1396a(a)(43), 1396(d)(r)(5).  The Federal law recognizes that this should include needed transportation.  The state should recognize this as well and continue to provide such services.

     Thank you for the opportunity to comment on these regulations.  If you have questions about the concerns we raised please do not hesitate to contact me at 255-2840. 

Sincerely,

Jama Fisk        

Staff Attorney