- Associated Press - Thursday, April 5, 2018

ALBUQUERQUE, N.M. (AP) - Four candidates for governor of New Mexico squared off in a forum Thursday about how to shore up care networks for the severely disabled, elderly and residents coping with addiction and mental health issues.

Specialty health care providers sponsored the discussion about shortages in the health care workforce, burdens of an aging state population and responses to Medicaid reforms sought by the Trump administration.

The conversation at a university auditorium in Albuquerque veered off into prescriptions for reviving a lagging state economy and delved into mental health issues linked to gun violence.

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Seizing on concerns about workforce shortages in health care, U.S. Congressman and gubernatorial candidate Steve Pearce said he wants to require “able-bodied” adults to “go back to work” if they are on Medicaid. He said later that work could be in the form of apprenticeships that lead to new opportunities.

The Trump administration in January said it would allow states to impose work requirements on Medicaid recipients. It already approved proposals from Kentucky, Indiana and Arkansas. More than one-third of New Mexico residents are enrolled in Medicaid health care for people with low incomes and disabilities.

Pearce, the sole Republican candidate, and three Democrats are vying to succeed GOP New Mexico Gov. Susana Martinez, who cannot run for a third consecutive term in fall.

The Democratic nomination is being sought by Congresswoman Michelle Lujan Grisham of Albuquerque, state Sen. Joseph Cervantes of Las Cruces and former media executive Jeff Apodaca of Albuquerque.

Lujan Grisham on Thursday stressed her knowledge of public health issues and concern for elderly care, ticking off past accomplishments as head of the state Department of Aging and Long-Term Services, and a three-year stint as state health secretary.

Cervantes highlighted his business expertise at running a family agricultural business in Dona Ana County, and said he would apply his experience as a state lawmaker to making services for the disabled a higher budget priority.

New Mexico maintains a decade-long wait lists for its coveted 24-hour care program for people afflicted at a young age by severe developmental or intellectual disabilities - from neurological disorders such as cerebral palsy to Down syndrome and other genetic conditions. The Legislature and Martinez this year approved new spending to shore up the program and move 90 people off the waiting list of about 4,200.

Apodoca, the son of a governor, cast himself as the only nonpolitician in his first run for public office.

Like other candidates, he tied better mental health and disability services to efforts to improve the economy that will result in more tax revenues. Apodaca wants a 5 percent local investment quota for the state’s sovereign wealth funds that hold more than $20 billion.

The candidates diverged sharply on a question about gun violence, mental health services and the responsibilities of state government.

Lujan Grisham, a proponent of banning assault-style weapons and high-capacity ammunition magazines, said New Mexico should study gun violence as a public health issue and shore up school-based health centers that intervene in behavior problems.

Pearce highlighted failures of local law enforcement and the FBI in the February mass shooting at Marjory Stoneman Douglas High School in Parkland, Florida.

He said that “we have to understand the interaction up front, before it gets to the shooting stage, before it gets to the violence stage.”

Providers of mental health and addiction treatment say they are still reeling from a false alarm over Medicaid fraud under Martinez that upended the industry, Maggie McCowen said, executive director of the New Mexico Behavior Health Providers’ Association.

In 2013, Martinez’s administration froze payments to 15 nonprofits that provided mental health services to the state’s most needy residents after an audit identified $36 million in Medicaid overpayments. An investigation by the state attorney general found no patterns of fraud, only regulatory violations - but by then many local nonprofits had been replaced with companies from Arizona that have gradually withdrawn.

McCowen also said reimbursement rates to care providers from Medicaid and employer health insurance plans are not keeping pace with the escalating costs of meeting regulatory requirements - a situation that is hollowing out the workforce.

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