What happened during the inaugural session of the current administration? First let me be clear that, although we did not get the Medicaid inclusion bill or the up-dated Practice Act passed during this session, we did have an extremely successful session.

Two highly amicable meetings were held with Paula Hyde, Secretary of the Department of Human Services, and several "sidewalk" sessions with Mr. Roger Gillespie, Deputy Director of the Medical Assistance Division, resulted in establishing a good dialogue with these key people within the department that oversees Medicaid. We also had a number of meeting with Pam Montoya, Secretary of the Department of Health. Both of the Cabinet Secretaries are long-time chiropractic users and are in favor of adding chiropractic services with the Public Health System. We have rapid access to three Cabinet Secretaries and the Assistant Chief of Staff in the Governor's Office. This was the first session that we worked following a change of administration. I found it quite different than the mid-term sessions where we introduced legislation in the past.

I created a general reference packet of more than 500 pages that touched on all issues related to chiropractic from the basic education and training, licensed rights and responsibilities to the current pediatric and primary care literature, cost analysis, and the methods that have been designed within the Veterans Administration for integrating chiropractors into the established Public Health Care Delivery System. Mr. Gillespie has begun to study the entire document to better educate himself regarding our profession.

I also learned a great deal during this session about advance planning and the need to have more voices and bodies present at times. Much of that goes to the desperate need that we have in this state to be more organized and to communicate with each other much more regularly. This task falls to District Directors and the Officers of the NMCA. We must have the ability to generate constituent support in the form of calls and faxes to promote our legislative issues. This has to be able to be coordinated, rapidly at times, to demonstrate that the citizens and voters of New Mexico support our causes.

HB-91, Chiropractic Inclusion Into Medicaid

Early in the session we met with Secretary Hyde. She informed us of her support for inclusion, but was not familiar with the budget and asked us to hold off presenting our bill during the session. We decided to introduce the legislation and did find that the Deputy Director spoke in Committee in opposition to our bill for budgeting reasons. This resulted in stern questioning from Rep. Patty Lundstrum (Gallup), a staunch and vocal supporter of chiropractic issues. She had asked that our inclusion be brought up during the Medicaid Reform Committee meetings during the summer and fall. When she found out that the issue was not addressed by the Committee, she chastised the Deputy Director and wrote a complaint to the administration. This may assure that our issues are discussed and may result in the appointment of a chiropractor to the interim committee.

Rep. Lundstrum is considering a run for the PRC position held by Commissioner Lovejoy. The district includes part of Bernalillo County and all of the western and northwestern counties in the state. You will be asked to endorse, support, donate and assist her in any way that you can should she decide to run for that office.

The bill progressed through the House Committees with the expected Republican opposition. As I was sitting on the floor of the House after being credentialed to testify during Floor debate on the bill, another legislator asked Chairman Coll (Appropriations) to pull the bill and send it back to his committee. We capitulated with his request and let the bill die there with a great many other bills because of budgeting concerns. While I have not received specific confirmation, I noted that the legislator that was whispering in Chairman Coll's ear immediately before he asked us to pull the bill off the floor was the same legislator that introduced a number of bills for the Acupuncturists. The opposition of our legislative package by the Acupuncturists became more evident when they opposed our Practice Act changes. They ambushed us severely and clearly demonstrated that they are not friends of our.

I presented a number of names to the administration and legislative leadership of chiropractors that are qualified to serve on committees and other appointed positions related to healthcare delivery, reform and access. I will speak with each of you that I nominated to explain the apparent roles that might be played on the committees.

Chiropractic Practice Act

This bill suffered defeat due to the ambush by the Acupuncturists and by not having early communication regarding sponsorship and potential stumbling blocks. We amended the bill, re-inserting the prohibition to the use of controlled substances and operative surgery but then came up against PT's and DOM's. The committee hearings were late at night and we failed to generate the number of individuals to show the professional and public support that might have quieted the opposition. I also found that having meetings to review methods and strategies for testifying before committees would be extremely valuable. We tried to have one during the first week of March but could not get a single DC from Santa Fe area to attend. This is important to change. The DC's outside of Santa Fe cannot get to the Round House at short notice and we must depend on the Santa Fe doctors to be involved and make themselves available when needed. We all have practices, but if we do not make the time and sacrifices necessary those practices may be in jeopardy. The Santa Fe directors are aware of the problem and have proposed proactive methods of addressing them during the next session. If a special session is called related to healthcare, we will introduce both pieces of legislation again and will need to have meetings in Santa Fe to review what should be emphasized and what should be minimized or clarified during testimony. We also need to have each director create a phone tree so that doctors and their patients can call and fax the legislators that we need to pass our bills through the committees. Many of the Cabinet Secretaries, key support staff, legislators and their families are treated by our members. Those doctors must be able to explain the issues related to our legislation and defuse misinformation presented by non-chiropractic health care providers that would and have adversely affected our legislation.

We will not compromise our practice act changes beyond controlled substances and surgery. This is necessary to allow DC's to be places in established public health clinics and facilities within the Veterans Administration health care system. These two issues are related to what the ACA has done nationally. The VA is rapidly adding DC's to their hospital staffs across the country and our inclusion into the National Health Service Corps with Federal money to assist planning and implementation. The Human Services Secretary can include us without legislation and I am working toward that goal with the good relations that seem to have been developed. This does not mean that we won't continue to legislate the mandatory inclusion; it only helps generate the Department's support of our legislation.
Secretary Montoya made an interesting comment during our first meeting. She said that she had two primary concerns regarding chiropractic. The first was access. She found it difficult to get into any chiropractors office because of her work schedule and suggested that chiropractors try to increase the hours and days of accessibility to reflect the rest of the healthcare provider facilities (urgent care centers). Her second concern was the lack of political involvement that she found within the profession. She said that getting chiropractors involved in local, state, regional and national politics is vital to being considered as a profession with public support and professional interest in the issues related to health promotion and cost effectiveness.

We are well on our way to greatly enlarging the size of the pie and increasing the role of chiropractors within the public and federal healthcare delivery systems. The need for DC's to work together has never been greater. Creating offices that incorporate multiple DC's with expanded hours and services must be addressed. Each of us must learn to work within a structured system respecting the professional roles of other practitioners, the protocols necessary in the administration of public health care and the knowledge of our place within the healthcare system that other professional participants will learn by our integration within the established delivery systems and facilities.

Ask your District Director to schedule a legislative meeting and help that person create a communication network within your District. Participate to advance. Participate to educate. Participate to succeed. Participate for the benefit of your patients, family and those future DC's that are depending on us to keep the profession moving forward to assume our rightful and proper position within the health care system.

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