I was so excited about how much support I received at the Taos Health and Human Services Meeting on June 18th, when I brought up the issue of Medicaid coverage for chiropractic service, that I actually had a hard time sleeping afterwards. I was truly stunned and elated. I thought about how much has changed since the Wilk case and since I began working as a chiropractor in 1982.

Several hundred local citizens, both health care consumers and providers, gathered yesterday at a meeting hosted by the Secretaries of the Health and Human Services Departments: Pamela Hyde, Secretary of the Department of Human Services; Patricia Montoya, Secretary of the Health Department; Mary Dale Bolson, Secretary of the Children, Youth, and Families Department and a man that I believe is the Undersecretary Designate for the newly forming New Mexico Aging and Long-Term Care Department. (Michelle Lujan Grisham, the Secretary Designate of that Department, was not present.)

Contained within the initial presentations made by the Secretaries was a summary of A Proposed Health Care Agenda for New Mexico and a draft paper on Medicaid System Redesign: Ideas and Possibilities. Prominent in the latter paper and the slide presentation was a proposal to include coverage for alternative practitioners, including chiropractors.

At the end of the initial presentations, the speakers asked for questions from the audience. I rose and said that I had been mistakenly certified and informed that I would b reimbursed for treating Medicaid patients approximately six years ago. I had found it so rewarding to treat these patients for a three month period that I am committed to working toward inclusion of chiropractic services in the future. I asked whether the Secretaries were looking at the potential health care cost savings from the inclusion of chiropractic services in the Medicaid program rather than viewing them as an added expense. I saw at least three or four Secretaries nodding, and Pamela Hyde responded that they are looking at those benefits and that they realize chiropractic inclusion has to be done right. She said that she believes in the benefits of chiropractic and acupuncture. She said that we have to figure out how to do this so that there will not be a duplication of service such as a patient receiving pain medications from a medical doctor while also seeing a chiropractor. I did not take issue at that time with the last part of her response because she seemed clearly quite enthusiastic about chiropractic inclusion.

When the question and answer period was over, the attendees split into four sub-groups so that the Secretaries could engage in discussion for another hour and a half with smaller groups of people. I participated in Pamela Hyde's group discussing Medicaid. My participation in the discussion focused on my experience treating Medicaid patients and my suggestions about what role chiropractors might play in the Medicaid system. I said that I had been asked to evaluate a four-year-old who had been severely abused and previously had multiple bones broken. I evaluated her musculoskeletal health and made suggestions regarding her treatment. I also treated a 16-year-old from the Casa de Corazon who had been using alcohol and drugs to self-medicate because she had a chronic pain condition caused by an auto accident when she was 10-years-old. She had never received adequate treatment for her pain condition; and, unfortunately, the drug treatment programs in which she participated had mistakenly thought that her pain would go away when she came off the drugs. I have also treated adult disabled individuals, who have new injuries or aggravations of their conditions, and need care to restore them to a status where caring for themselves is possible. And, I have also been asked to treat pregnant women who have back pain and sciatica and need care so that they will be healthy enough to have a normal delivery. I mentioned that in Taos we have a good working relationship with the medical doctors and I felt we could work together without duplication of services.

Across from me were seated four medical doctors and a midwife. One of the medical doctors spoke up at this point and said that she took issue with what was said earlier about duplication if a patient received pain medication from the medical doctor and saw a chiropractor as well. The midwife said that a patient with an acute injury may need pain medication, "and may also need to see Lucy." Pamela Hyde said that she was in agreement and that she herself sees an acupuncturist and a chiropractor, as well as her medical doctor. She said that when it comes time to make specific legislative proposals, she might need members of the medical community to testify about this matter to the effect that they can foresee how chiropractic services could be included in a beneficial manner. At least several of the medical doctors and the midwife nodded their assent. Ms. Hyde also said that she would appreciate any information that I could provide that would address the issue of cost savings from chiropractic care.

During the rest of the discussion, I tried to be as supportive as possible to the medical doctors who had very real concerns regarding Medicaid due to the high percentages of their patient loads that are comprised of Medicaid patients (due to the fact that we are in a poor rural county).

At the end of the session, I thanked Secretary Hyde and she remarked that she was thinking about the fact that only medical doctors are on the Medicaid Advisory Board. She asked for my card.

I am in the process of putting together information regarding cost savings from chiropractic care and would appreciate any ideas and suggestions from my colleagues. Please contact me with anything you feel might be important at 505-776-1117 or by e-mail address lwf@newmex.com.

In the meantime, I will be floating on air for awhile and my eyes will be misting over when I think about how great it is to be part of such a time of change.

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