New problems are mounting at Los Lunas Community Program, New Mexico's only state-run health center for developmentally disabled patients. Disputes over properly trained staff, sound prescriptions and levels of care have clouded the center's history—but while the state has closed privately run operations amid similar complaints, Los Lunas' doors remain open.
"A number of provider agencies have been shut down, and not one of them has been the target of Department of Health investigations for nearly this long," Peter Cubra, an attorney who represents Los Lunas patients, tells SFR. Cubra says Los Lunas' pattern of failing to meet state standards has persisted since 2006.
Los Lunas uses money from the state's Developmental Disability Waiver Program, most of which is funded through Medicaid.
In 2010, ResCare, a private provider that received DD waiver money, forked over $15.5 million in a neglect lawsuit after the state ended the company's contract in 2006 for unspecified reasons. Another provider, Mosaic, has failed DOH compliance standards in the past and will be shut down this year amid Medicaid funding cuts.
Johanne Guyton, a senior advocate with Disability Rights New Mexico, says Los Lunas is working to correct its failing standards.
"[Los Lunas] can still operate because the theory is, as long as they're working on a corrective action plan, they're making a legitimate effort to come into compliance," Guyton tells SFR.
Los Lunas' most recent breach came in a June 15 survey by the DOH's Division of Health Improvement—two years after Cubra and other lawyers filed a complaint highlighting the facility's failure to meet standards.
The June report found Los Lunas failing to meet 25 compliance standards, ranging from the trivial (failing to make a medication record on a patient's daily multivitamin dose) to the potentially severe (failing to report incidents of suspected abuse and neglect).
The latter point sticks with Ann McCartney, another attorney representing Los Lunas patients.
McCartney blames many of Los Lunas' failures on a mind-set left over from its past incarnation as a state institution. The facility was shut down in the mid-'90s as the state shifted gears from treating developmentally disabled patients with institutionalized care to more intimate community and family care.
Los Lunas soon reopened as a community care center.
All of this came as a part of the 25-year-old Jackson class action lawsuit, which was sparked by an institutionalized patient who suffered severe burns after drinking oven cleaner. More than 40 patients who receive treatment from Los Lunas are members of the Jackson class; Cubra, McCartney and three other lawyers represent them.
While the state has for years recorded standards violations at private health providers such as Mosaic, Los Lunas has been singled out more consistently, McCartney says, because it is the only state-run program for the developmentally disabled.
"There's more entrenchment around Los Lunas because it is a state facility," McCartney tells SFR.
Fritzi Hardy, who chairs New Mexico Family Providers, a group of volunteers who support family providers under the DD Waiver, points out that Los Lunas' staff are state employees with better pay and benefits than those who work for the private care centers, which adds to the pressure to keep Los Lunas running.
While the DOH audits Los Lunas, it's also essentially in charge of it. All SFR inquiries to Los Lunas were deflected to the DOH.
Since the June report, Los Lunas has submitted a plan of correction to remedy the violations by contracting with a new pharmacy, retraining staff members, disciplining others and starting a new auditing process. In an email to SFR, DOH spokeswoman Aimee Barabe writes that the corrections "will be ongoing until completed." Los Lunas has until Sept. 12 to make the corrections, according to a DOH document.
But the plan hasn't yet been provided to the attorneys, McCartney says. An Aug. 12 meeting between Jackson lawyers and DOH representatives revealed another problem: Los Lunas has two unfilled nursing positions, one of which works with the "medically fragile," McCartney says.