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How do we attract doctors and healthcare workers? Think tank has a plan

By Sherry Robinson

All She Wrote

How long does it take you to get an appointment with your doctor? If your answer is weeks or months, or “What doctor?” Think New Mexico has you in mind.

The nonpartisan think tank recently published a plan to solve New Mexico’s healthcare worker shortage. The group has done its usual thorough work of defining the problem and presenting a potentially do-able solution.

Most riveting, I thought, is the part about reforming the state’s medical malpractice act. This 48-year-old law, its changes and loopholes are a giveaway to malpractice attorneys. We might as well buy national advertising warning doctors to stay away from New Mexico. Here are a few alarming facts from the report:

New Mexico ranks second highest in the nation for the number of medical malpractice lawsuits per capita. The number is more than twice the national average.
Medical malpractice insurance premiums are nearly twice as high as they are in Arizona, Colorado and Texas, and the costs are growing.
Even with spiraling premiums, many malpractice insurance companies lose money. The statewide loss ratio for medical malpractice insurers was highest in the nation in 2022, at 183.6%. So for every $100 insurers received, they paid out $183.60.

“The high cost of malpractice insurance, and the high likelihood of being sued, discourage doctors and other health care workers from practicing in New Mexico,” says Think New Mexico. It’s not that our doctors are worse; we have “a system in place that incentivizes lawyers to file malpractice lawsuits here,” according to the report.Think New Mexico recommends six reforms:

Cap attorney’s fees. Lawyers receive 30% to 40% of the verdict. That’s money that the patient doesn’t receive for future medical care. Lawyers are entitled to a reasonable living but not “multi-million dollar windfalls at the expense of gravely injured patients.”
End lump-sum payouts. Previously, the patient’s treatment over time was paid as expenses were incurred. In 2021 lawmakers reached a hard-won compromise on a controversial medical malpractice reform bill. In the uproar, somebody sneaked in wording that allowed a single, lump-sum payout based on an estimate of the client’s lifetime medical costs. But after the attorney’s share, the patient may not have enough left.
Stop venue shopping. Lawyers can file medical malpractice lawsuits anywhere in the state, and they prefer places with sympathetic juries. Thirty states now require suits to be filed in the county where the alleged malpractice occurred. In New Mexico, “trial lawyers have repeatedly racked up record-breaking verdicts.”
Raise the legal standard for punitive damages and cap them. The 2021 changes to malpractice law allow the highest caps of the 29 states that cap malpractice liabililty, and punitive damages aren’t capped. While punitive damages are rare in other places, they’re routine here, and unlike 32 other states, our burden of proof is minimal.
Prohibit lawyers from filing multiple lawsuits over a single malpractice incident – a way lawyers get around caps on damages.
Require that damages awarded for future medical costs reflect the actual cost of care.

Spend five minutes in the Roundhouse and you quickly see the chummy relationship between the New Mexico Trial Lawyers Association and progressive Democrats. The 2021 changes passed with their support.

Then-Sen. Gay Kernan, R-Hobbs, said later: “It was the worst vote I have ever taken.” Doctors weren’t in the room, and the negotiation was “flawed from the beginning.” She voted for it out of fear the caps could disappear.

Last year another medical malpractice bill threatened to shutter outpatient facilities. Republicans opposed it. Dems dithered until the governor pulled their heads from the sand.

When legislators ask for your vote, question them about medical malpractice reform. The answer will show whether or not they’re working for you.

We celebrate 20 years of columns

By Sherry Robinson

All She Wrote

“I want to stop and smell the roses,” he said. “If you want it, you can have it. Otherwise I’m going to shut it down.”

That was newsman Hal Rhodes, founder of New Mexico News Services. He had started NMNS in 1997 to provide opinion columns to New Mexico newspapers. When Hal was ready to step aside in 2004, he passed the baton to me.

We are now celebrating 20 years of a tiny business. The writers and some of our newspapers have changed but not the mission, and that is to provide views on New Mexico issues by New Mexico writers based on long experience and reporting.

In 20 years and thousands of columns some of the issues and players have changed, and public discussion is more intense. Past columns mark progress and paralysis.

On Oct. 1, 2004, my first column was about the film industry. Movie makers had chosen Clovis to film “Believe in Me” about a girls’ basketball team in a small town. When production crews arrived in Clovis, theywere greeted with banners and signs saying, “Believe in Clovis!” The Hollywood folks were touched. That’s not the treatment they get in L.A. or New York.

I wrote, “What we need now is a production studio to keep more of this work in the state.” Now we have multiple studios.

On the same date my late friend Harold Morgan delivered the first of many pronouncements on the economy: “The national economy is in decent shape. New Mexico is another story.” Unemployment claims were down, but wages here were lower than the national average. The state’s productivity only looked good with Intel in the picture. Subtract Intel and our productivity plunged, and that too meant lower wages. “The only answer is education,” Harold wrote. “If New Mexico workers offer more to employers, the wages will be higher.”

In some areas New Mexico evolved. We worked through such challenges as casinos and bad behavior at the Public Regulation Commission, but in other ways the state remained stuck.

Mary Dale Bolson, secretary of the state Children Youth and Families Department, talked 20 years ago about the importance of teachers to kids, especially lonely, isolated kids who don’t necessarily come to the attention of the state. She talked about the importance of respect, acceptance and listening.

I wrote: “What the charter schools – and education reform – try to do is achieve a smaller class size. Reformers believe, correctly, that it improves learning, but Bolson points out that it also ‘meets a child’s need for attachment.’ The best of the new programs (and the old) offer kids a mentor and an emotional anchor.”

We’re still talking about smaller class size.

2004 was an election year, and the pattern is little changed. I wrote about swing voters: “So far the list has included Hispanic people, ‘Security Moms,’ NASCAR guys, middle-aged women and the Religious Right. Fact is, in a presidential election this close and this polarized, anybody could be a swing voter – barbershop quartets, barbed-wire collectors or one-armed paper hangers.”

In the same vein, I quoted a woman saying that she and her husband didn’t share the same political beliefs and didn’t talk politics. “It’s the elephant in the living room,” she said.

I wrote: “The elephants have certainly multiplied this year. In a charged atmosphere when nearly everyone has an opinion – and a strong one, at that – we’re all tiptoeing around elephants… These must be the most divisive races in memory.”

Little did I know.

It’s tempting to say, the more things change the more they stay the same, but I think it’s more complicated. A better recollection of recent history, successes and failures, would improve the quality of public discourse.

Buy a piece of history

By Sherry Robinson

All She Wrote

If you love historic hotels, and I do, it was a punch in the gut to read that the St. James Hotel in Cimarron has closed. The storied St. James not only has a big place in New Mexico history – punctuated by 26 bullet holes in the barroom ceiling – it’s a major employer in the tiny northern town.

After the announcement, the hotel’s Facebook page carried an outpouring of comments from grieving customers, Boy Scouts, former employees and locals who all hope the right person will step up to carry on the St. James legacy. And the search for a buyer is backed by the state Economic Development Department, which is circulating an appraisal and helping drum up interest. How do you put a price on history?

Henry Lambert, who had been a chef to Abraham Lincoln, started the St. James in 1872, and it soon became a favorite stopping place on the Santa Fe Trail. Visitors included famed lawman Wyatt Earp, wild west showman Buffalo Bill Cody, gunman Clay Allison, outlaw Jesse James and train robber Black Jack Ketchum. Former governor and author Lew Wallace wrote part of his novel "Ben Hur" here, and western writer Zane Grey composed stories sitting outside against an oak tree.

Lambert’s raucous saloon was the scene of more than two dozen killings. Some of the dead stayed around to provide the occasional ghost sighting. (That feature later became a tourist draw, although my stays at the St. James were quiet and uneventful.)

Eventually the railroad put the Santa Fe Trail out of business and, with it, the St. James. The hotel changed hands many times until 2009, when Oklahoman Bob Funk bought it and renovated it beautifully. He also bought the nearby Express UU Bar Ranch but sold it in 2018 to Zane Kiehne, one of the nation’s largest landowners, and leased it for cattle operations.

Now Funk wants to retire. He put the hotel on the market and stopped leasing the ranch. Kiehne’s plans for the ranch are unknown.

Teri Caid, the hotel’s general manager and the ranch’s operations manager, told The New Mexican that core staff members have been with the hotel for eight to 20 years, but like many operations it’s hard to keep kitchen and housekeeping staff. The St. James employed 58 people, and the ranch employs 18, including Teri’s husband John, who is ranch manager.

It’s a big hit for a town of 800 people. The Philmont Scout Ranch is the largest employer, and the hotel is the second largest.

Enter the state Economic Development Department. On Sept. 18 Tim Hagaman, regional representative to the northeast front range community on the Business and Rural Development Team, circulated a letter.

“I’m reaching out to as many friends as possible that can identify a new owner to purchase the property,” he wrote. “They are not giving the property away but serious buyers can convey what they think it is worth.”

The appraised value is $4 million, according to the firm representing Bob Funk. Yearly revenue was $1.5 million at 40% occupancy. The seller won’t accept a real estate contract. However, the Economic Development Department “can assist with up to $250,000 in collateral support.”

This is the New Mexico Collateral Assistance Program. “To support business growth in New Mexico and to create and retain jobs, EDD encourages banks and other financial institutions to make loans to small businesses in underserved markets. EDD can pledge cash to cover a collateral shortfall of a loan to enable financing that otherwise might not be available to a small business,” according to the website.

Hagaman writes hopefully that Tim Smith, Funk’s representative, “has been contacted by interested folks all over the country with ties to Philmont. If you have a serious buyer they can reach him at tsmith@okcproperties.com.”

County jails have a role in criminal justice reform

By Sherry Robinson

All She Wrote

Many people who break the law need drug treatment. That’s pretty common knowledge, but the state Corrections Department has no treatment program. Now, battered by a new state law and a lawsuit, the department will drag itself into the 21st century. Meanwhile, it’s sending inmates needing treatment back to county facilities.

That’s just one expense of many for county detention facilities.

Last November I wrote that crime discussions during the legislative session “must look at all the moving parts of the criminal justice system, including the humble county jail.”

They did. Counties got more money for detention officer recruiting and salaries and better reimbursement for their costs of housing the state’s inmates in county jails. But it’s not enough.

While counties appreciate the new appropriations, they need more. Grace Philips, risk management director for the New Mexico Association of Counties, explained why during a recent meeting of the interim Courts, Corrections and Justice Committee.

“Booking numbers are important,” Philips said. In fiscal 2024 statewide detention bookings totaled 83,779, up from 76,711 in 2023. The total has risen steadily since 2021. The average daily population this year was 5,404.

Ideally, a felony offender would be briefly incarcerated in the county where they were arrested. New Mexico has 25 county detention centers. But many detainees spend a lot of time in county facilities because they can get drug treatment in county jails that’s not available in state prison.

“Federal regulations require all corrections facilities to continue treatment and have a full fledged program,” said Philips. A law passed last year gave the department nearly two years to comply. However, a lawsuit settlement this year requires the Corrections Department to treat inmates’ opioid-use disorders now, although it still doesn’t have a program.

“Without access to their doctor-prescribed medication in prison, people with opioid-use disorder suffer painful and dangerous withdrawal and face a high risk of relapse, overdose, and death, both in prison and upon their release. It is cruel and illogical to deny this treatment to people,” said Tim Gardner, legal director of Disability Rights New Mexico, which brought the lawsuit with ACLU New Mexico.

Inmates currently have a bizarre choice. If they want to continue drug treatment they can stay in county facilities, which have fewer amenities, and they earn no time for good behavior. If they choose to be a state inmate, they don’t get drug treatment.

That’s one issue. The larger concern is that the state doesn’t pay its share of costs when counties house state inmates. Years ago, counties sued, and the court declared the state responsible for housing state inmates. In 2007 the lawmakers created the County Detention Facility Reimbursement Fund and appropriated $5 million for it. The balance dropped below $2.5 million before being replenished to $5 million in 2022.

Since 2019 the state has reimbursed a fraction of the actual cost of holding inmates, according to data from the association. In fiscal 2024 the state paid the counties $5 million of their $9.4 million cost. That’s up from paying about a quarter of costs in 2019.

In the next legislative session counties will ask for $8.2 million for the fund. That’s what the New Mexico Sentencing Commission calculates is the five-year average cost for counties to house state Corrections Department inmates.

“There is a big gap between the cost to counties and what the Legislature approves,” Philips said. She worries the divide get worse.

Another headache for counties is recruiting detention officers. They’re grateful for $2.8 million appropriated this year. Spread over three years, the funding will offset the cost of 189 positions at 22 entities, but requests totaled more than 850 positions.

We need to remember that getting criminals off the street is just the first step.

Science comes to the rescue of chile industry

By Sherry Robinson

All She Wrote

My local purveyor of roasted green chile has crowds of people waiting for their coveted yearly sack.

Just as predictable as the crowds are the doomsday predictions. This year it was “The chile crisis: Declining production amid labor, water challenges” from the Albuquerque Journal. Every year we hear about issues for growers, about threats to the state’s legacy as the nation’s largest chile producer.

One towering factor is trying to find workers. Here’s a job description posted on the U.S. Department of Labor website: “Hand pick quality (mature) green chile from plants into buckets (10 gallon). Worker will carry full bucket and chile and walk to trailer to dump into trailer and back. Must be able to lift up to 60 pounds. Worker must be able to work in diverse weather conditions (hot, dry, cold, wet, windy, and dew moisture). Able to bend, stoop, kneel, reach, walk across fields carrying 60 pound buckets and other related activities.”

For $15 an hour. Who wouldn’t jump at the chance, right? Who can resist “bend, stoop, kneel”? Americans have been resisting in droves.

Jhett Kendall Browne, a blogger, chef, and fourth generation chile roaster at Farmers Chile Market in Albuquerque, writes: “An open secret among the chile community is that many chile pickers are illegal immigrants. The fact is, picking chile is a grueling job requiring someone to hunch over a 2 foot chile plant in the summer sun with no shade all day. There are few ways to really improve this. It is just an incredibly difficult job with fewer and fewer people wanting to do it.”

He is grateful for the hard-working chile pickers.

Chile is labor intensive because many thousands of tons of green chile must be handpicked. Red chile can be mechanically harvested, but it’s only about 10% of the harvest.

Science is riding to the rescue, again. Over the years, plant scientists at New Mexico State University have given growers more disease-resistant plants, more productive plants, and even bigger, meatier chiles. Now they’re focused on the components of mechanical harvesting.

Mechanical chile harvesters have been around for years, but we’re talking about a delicate fruit that’s sold fresh and must be as flawless as tomatoes entered in the county fair. To date, mechanical pickers have bruised the merchandise. So machines had to improve, and scientists had to come up with a resilient fruit that was still tasty as well as a single-stemmed plant at the right height with fruit up high. They understood that some of the chiles would be damaged and compensated with productivity and a higher density of plants in the field. This is according to a study published in Hort Technology last spring.

“So one machine will take the place of what basically 60 people… do in a day,” grower Darren Gillis told KRWG. “So we're not really trying to eliminate jobs. We're just trying to fill jobs for people that aren't there anymore. And cost-wise, we can do it for probably half price of what it takes to do it by hand.”

Travis Day, executive director of the New Mexico Chile Association, called mechanized harvest “a big industry game changer” that wouldn’t “fully replace the hand picking of chile” but would help “farmers that really need that help to get their crop out of the field.

“You know, they're still not able to find American workers to pick their chile,” he said. So, yes, acreage and production are dropping, workers and water are both scarce, Mexico has become a big competitor, and other producers falsely label their chile as Hatch chile.

But this is a good season, there’s plenty of chile, and we’re still number one. For that we rejoice.

Mass deportation spelled out

By Sherry Robinson

All She Wrote

Presidential candidate Donald Trump is mining a vein of public discontent when he calls for mass deportation of undocumented immigrants. Recent polls show that Americans favor tighter restrictions on immigration, and Republicans resoundingly support mass deportation.

This would target an estimated 11 million people living here, although aspiring Vice President J. D. Vance cheerfully suggests starting with a million.

How exactly would that work?

I searched the latest thinking on the subject in media reports to give you an abbreviated view. The bare-bones process is identification and arrest, detention, legalities, and return to countries of origin. Each step is complicated.

Identification and arrest: Critics and supporters predict raids in workplaces, neighborhoods and other public places. Anybody, even U.S. citizens, could be questioned. In New Mexico, imagine the conversation with that grandma whose family has been here 20 generations.

Currently Immigration and Customs Enforcement (ICE) has 20,000 agents, not nearly enough to chase millions of people. Experts say ICE would need thousands more agents, along with help from law enforcement and the military.

Trump has promised to take action against sanctuary cities and counties that restrict police cooperation. Even then, police say they have bigger worries. The military hasn’t been involved in immigration except for occasional National Guard support at the border.

Detention: Detainees would have to be housed from arrest until deportation, which could take years. ICE manages 41,500 beds in 200 jails and detention centers at a cost of $57,378 per year per bed. For a mass deportation, that’s too little. A former White House adviser puts the needed holding capacity at upwards of 50,000, and Trump has said he’s open to building new facilities.

Legalities: Some 80% of undocumented immigrants have been here for more than 10 years. By law they have a right to due process, and that includes a court hearing before an immigration judge. Newer immigrants have been processed at the border and released with orders to appear for deportation hearings. For either kind of immigrant, the court system is years behind. Experts say that to process millions of immigrants, immigration court should be triple the size. That would mean new courthouses and many more judges and support staff.

And we know that immigrant rights advocates and the ACLU will be busy in court.

If a president wants to override any of this, Congress would have to change the law, and Congress has been stalled on immigration law for two decades.

Return: Deporting people is no longer a bus ride across the southern border. Immigrants now come from South America, China, India, Africa and even Europe. The countries of origin must be willing to take them back, and they can say no. If the immigrants can’t be immediately returned, ICE is not allowed to hold them indefinitely.

In fiscal 2023 ICE deported 142,580 people on a budget of $420 million. The agency has used charter and commercial flights. Trump has talked about using military planes, but costs could soar. Ramping up for a roundup like this could cost hundreds of billions of dollars, experts say. It would also require unprecedented cooperation among many government agencies.

The Wall Street Journal has declared that mass deportation would be a disaster. The Economist calls mass deportations a fantasy and adds that “even unsuccessful attempts could breed chaos.” Immigration experts and former Homeland Security Department officials have said in multiple interviews that mass deportation faces so many logistical, legal and financial obstacles that it can’t be done in four years, if ever.

Said a former Border Patrol agent: "I honestly just don’t see it happening. One, because I think it’s political suicide, and two, I think we need to focus on national security issues."

Scions of two political families

By Sherry Robinson

All She Wrote

One day apart, Robert F. Kennedy Jr. ended his presidential campaign, and Jeff Apodaca defended The New Mexico Project in court.

The scions of two political families are very different personally, but both have struggled to carve out their place in public life. Both stepped outside the inherited cocoon of the Democratic Party and attempted to cut a path through the political jungle on their own.

Kennedy at his core is a tragic figure. At 14 he saw his father killed on national TV. He wasn’t close to his mother, a widow with 11 children. He criticized investigations of his father’s and uncle’s assassinations and embraced conspiracy theories. He enjoyed successes at Harvard and as an environmentalist, but he was given to depression and the constant sense that there was a hole in his life, which he tried to fill with drugs and women, according to media accounts.

A friend once said Kennedy always wanted to run for president but assumed his reckless behavior would rule that out. Enter Donald Trump. Kennedy admitted to an interviewer that Trump’s candidacy enlarged his concept of what was possible. And Kennedy had found a vehicle in his opposition to vaccines, which got more play during the COVID years, despite the opposition of doctors, scientists and his own family.

Pundits usually described Kennedy’s campaign as quixotic, but a few were also surprised that he polled better than expected.

Meanwhile, Apodaca, our home-grown scion, is doing battle with the state Ethics Commission.

Apodaca is a somewhat tragic figure. Son of the late Gov. Jerry Apodaca and the well regarded Clara Apodaca, he played football in high school and college but had to overcome cancer at age 17. He graduated in 1986 with a B.A. in broadcast management and had a successful 30-year career in the media, rising to executive positions at CBS, Univision and others.

Apodaca could have retired and enjoyed himself, but he wanted a second chapter in his life and yielded to the political itch. He ran for governor in 2018 as a Democrat but was no match for Michelle Lujan Grisham. Nobody called his campaign quixotic, but one columnist called him a “featherweight.” In his campaign rhetoric Apodaca annoyed and offended Dems, although maybe not as much as Kennedy.

A few months ago I wrote about Apodaca’s idea of raising money to support moderates of both parties through The New Mexico Project. Because Democrats were then persecuting their moderates, I thought Apodaca hit on a good idea.

He ran afoul of transparency watchdogs like New Mexico In Depth, which called the project another dark money group and pushed the project to report campaign donations. The state Ethics Commission sued to force the project to disclose sources of funding that bought political ads supporting legislative candidates in the primary.

Lately, reported the Albuquerque Journal, Apodaca blamed Democratic progressives for "weaponizing" the Ethics Commission. That’s starting to be an old accusation. Lawmakers worried when they created the commission that it could be used politically, so they tried to protect the accused and give them the benefit of the doubt, among other protections.

Apodaca insists the project is an education group. On the radio he said that “we’re going in and educating the voters on what we need to do to get out and vote and vote for the right candidates.” Sound like a political campaign?

If it walks like a duck and quacks like a duck…

Then there’s Source New Mexico’s report about Apodaca accelerating a truck through pro-Palestinian protesters during a demonstration. Nobody was hurt, but it was another hit on his reputation.

Something Apodaca and Kennedy share, besides fringe candidacies, is a wacky edge. Apodaca can back away from that edge if he chooses. For Kennedy, it’s a little late.

Las Cruces’ sanctioned homeless encampment works

By Sherry Robinson

All She Wrote

Since the U.S. Supreme Court blessed local government bans on public camping, many have tried to sweep away their homeless camps. They just pop up again somewhere else, or individuals fan out to new places.

Where are they supposed to go? Courts don’t answer that question. Neither do local governments.

Except Las Cruces, where Camp Hope, a sanctioned homeless encampment, has been thriving for 13 years at no cost to taxpayers. I often wonder why officials of every New Mexico community with a homeless problem haven’t made a pilgrimage south to see the Las Cruces model.

Camp Hope began in 2011 as an experiment. Nicole Martinez, executive director of the nonprofit Mesilla Valley Community of Hope (MVCH), asked the city for a three-month trial of a small tent camp on city land to give people living on the street a temporary place to stay. The city agreed.

Today Camp Hope can house up to 50 people in tents. Many tents are in three-walled, roofed shelters that protect them from sun and wind. The camp has restrooms, showers, laundry, kitchen and a community garden. Next door at MVCH, residents have access to a food bank, medical care, case management and a menu of services to help them get back on their feet.

Camp Hope hasn’t hobbled its programs with so many restrictions that people are discouraged from getting shelter. People can keep their pets. They can’t use drugs or alcohol on site, but if they return to camp after imbibing elsewhere, they can stay as long as they don’t bother others. There is no minimum or maximum stay.

The camp does have rules (no violence, no weapons, help with maintenance, for example), but it’s largely governed by residents, who have helped make the rules.

Camp Hope operates on the principle of Housing First, which holds that people can’t effectively respond to treatment and help until they’re safely housed. Once they have the basics, residents are more open to such services as behavioral health treatment, education and training, or eventually permanent housing.

Some residents aren’t ready to move quickly from tent to apartment – they need some transition time to develop trust and self-confidence. Camp Hope allows this transition time, but managers are clear that permanent housing is the ultimate goal.

“I see this 100 percent as a good investment for the city,” Natalie Green, Las Cruces’ Housing and Neighborhood Services manager, told Searchlight New Mexico in 2022. “Studies show that when we house someone experiencing homelessness, it’s much more cost-effective.”

Last year the Legislative Finance Committee reported that the homeless population statewide had grown by 48% to about 4,000, and that’s probably a dramatic undercount. The increase goes hand in hand with the lack of affordable housing. Wages can’t keep up with spiraling rents, and affordable rentals are half what they were in 2020.

Our largest cities have the worst shortages, but the report showed seven rural counties in the next tier of need: Curry, Grant, McKinley, Otero, Rio Arriba, San Juan and San Miguel.

Albuquerque, Santa Fe and Española have waged the most public struggles with their homelessness, and they’re no closer to a solution.

Since closing the unsupervised camp in Coronado Park in 2022, Albuquerque has tents scattered around the city. Albuquerque and Santa Fe refuse to consider sanctioned camps mostly out of NIMBYism. The prevailing sentiment: Take care of “those people” somewhere else. Albuquerque actually had a nonprofit ready to supervise an encampment; after blowback city councilors ran the other way. Santa Fe didn’t get that far.

From my time volunteering at a homeless center, I know this group varies from working people who simply can’t find affordable rentals to the most down-and-out addict. They will respond to choices individually. For some, the sanctioned encampment is a godsend.

All’s fair in healthcare worker recruiting

By Sherry Robinson

All She Wrote

Around Houston Medical Center are six billboards inviting its employees to come to New Mexico, where they will be “Free to Provide.” The message is repeated in full page ads in the Sunday editions of dailies in San Antonio, Austin, Dallas, Fort Worth and Houston.

New Mexico’s governor and state Health Department are taking advantage of turmoil in the Texas medical community caused by changes in abortion laws to recruit healthcare workers.

Our shortage of practitioners is well known; some rural hospitals have closed their obstetrics wards. And how is your personal access to healthcare? My own gynecologist is pressed to see his patients and still try to answer their questions. I’m lucky to have a few minutes of attention. However, for some people this is a touchy subject. The campaign, paid for by taxpayers, could just bring more abortion doctors, say critics.

Let’s look at this.

Texas has a problem. Its ban on abortions after the sixth week has been in effect since 2021. After the U.S. Supreme Court’s Dobbs decision overturned Roe v. Wade, the Texas law became a near-total ban on abortion. The Texas Supreme Court upheld the ban in May when a group of women sued over emergency exceptions. Some patients have been outspoken about the law’s impact when they’ve had complications.

In a letter accompanying the ads, the governor informs providers that New Mexico permits abortions and protects medical practitioners who administer them. And she wades into the controversy, telling them: “When you pledged to dedicate your lives to medicine, you did so with the understanding that the health and well-being of your patients would always be your priority. You took your oath with patients––not politicians––in mind.”

The Free to Provide website doesn’t mention abortion specifically but does provide information about jobs of all kinds across the state, as well as scholarship opportunities, and even some tourist information about destinations and cultural events. How many doctors or nurses or therapists or whatever, who are ten years from retirement, might come visit with an eye toward practicing here and then retiring in place?

Health Department Secretary Patrick Allen made that point when he wrote recently that New Mexico needs healthcare providers. “By that, I mean all sorts of medical professionals – general practitioners, dentists, obstetricians, gynecologists, behavioral health experts, pediatricians, surgeons, nurses, neurologists, and psychiatrists, among others.”

I would add that when we talk about crime, including the mentally ill people who are repeat offenders, and the subject turns to treatment, as it did during the special legislative session, we don’t have the professionals who can treat them.

Hospitals, clinics and other employers don’t see it as abortion recruiting. More than 100 of them are participating in the campaign and posting job opportunities, Allen wrote.

I don’t think most people want New Mexico to become the abortion capital of the nation, but Texas has pushed us in that direction. According to the Guttmacher Institute, 14,200 patients from Texas came here for abortions last year. That was a 260% increase since 2020. We might sympathize with the Texas women, but that kind of increase puts pressure on New Mexico’s already thin healthcare system.

Patrick Allen may be avoiding politics, but his boss isn’t. The governor’s letter was a poke in the eye to Texas Gov. Greg Abbott. He poked back, calling the campaign a political stunt and bragging on his state’s economic successes. “People and businesses vote with their feet,” he said, warning our governor to pay attention to New Mexico problems.

Abbott, who is no stranger to political stunts, has inflamed border issues. But that’s a whole ‘nother column.

Cold food, cold coffee: senior care facilities can do better

By Sherry Robinson

All She Wrote

Two recent studies of New Mexico’s senior care facilities ring alarm bells.In June the news organization ProPublica published a report that ranked New Mexico nursing homes fifth in serious deficiencies (Texas was first!); in the last three years, 28 of 68 homes had at least one deficiency causing "immediate jeopardy."

And recently the state Department of Health reported that after surprise inspections at one third of New Mexico’s senior care facilities, only 11 of 91 passed muster and about half scored 90%.

Given my family’s dismal experience with these places, this was better than I expected. But it’s not good enough for Health Secretary Patrick Allen or the governor, who found the quality of long-term care wanting.

Horror stories are common, and the problem is nationwide.

In May Health Department inspectors, armed with questionnaires, fanned out over 13 counties and visited 91 of 268 facilities, noting observations and interviewing residents. Eleven captured a perfect score, and four failed and were reported to the Abuse, Neglect and Exploitation hotline. The state found at least one violation in 88% of facilities.

Residents’ top concerns were food, boredom and how they’re treated. Inspectors also looked at cleanliness, atmosphere, communications and privacy.

Good food is apparently so hard to achieve that otherwise high-scoring facilities struggle. Said one Albuquerque resident, “They deliver breakfast really late… and it is always cold, and the coffee is cold.” A Belen resident gave her facility high marks for staff treatment and activities but panned the food, saying she wanted more protein and less starch. A Gallup resident was tired of eating mutton all the time.

For too many facilities, “activities” amount to a TV set. In some cases, residents can’t even change channels, and they never get to go anywhere. They’re lonely and sad, said one person. However, at a Taos facility, residents enjoy a variety of activities and praised the activities coordinator.

Treatment of residents is generally good, but a small percentage of staff ignore residents when they need help, don’t bother to knock before entering their rooms, and don’t respond to requests for room repairs. Said one resident in Gallup, “The staff are mean. They will not say hi and will get mad sometimes.” At another facility, a resident said they needed more staff. Wait times were so long that “sometimes a bowel movement happens before they come to help.”

Inspectors found that facilities don’t meet the sniff test. The place smells of cleaning agents – or worse. Some areas or the residents themselves smelled strongly of urine and feces. In one incident reported to the hotline, a resident recovering from a recent surgery asked for help changing herself at 9 p.m., but didn’t get it for 12 hours.

The Health Department believes it’s a basic responsibility to make sure residents are clean, groomed, and dressed in clean clothes that fit. Thirteen facilities failed in these categories. Some residents couldn’t shower every day. One woman had only hospital gowns to wear. And residents’ clothing went missing when sent to the laundry.

Inspectors looked at whether the atmosphere was institutional or homey. One Gallup resident said they couldn’t use the phone to call their families, couldn’t put anything up on the walls in their rooms, and had no privacy.

Some of this dysfunction is simply short staffing and high turnover. “Staff keep leaving,” said a resident. “The cook left and now the food is awful. There used to be more activities, but the activities director left so recently there is nothing going on.”

ProPublica recorded turnover at the 68 nursing homes that ranged from 26.1% to 89.3% and was most often in the high ranges. No organization can function properly with this head-spinning level of staff change. If the state isn’t looking at staffing and turnover, it should be.

Governors with their dukes up

By Sherry Robinson

All She Wrote

Former Gov. Susana Martinez once described her first legislative session, in 2011, as “hand-to-hand combat.”

A former DA, Martinez had no experience with the Legislature, and went in swinging. She used campaign rhetoric, radio ads and robo calls to browbeat them and even sent a staff member to videotape them as they debated.

She said Senate Majority Leader Michael Sanchez “chose to play politics with our children’s future.”

Of the film tax credit, she said, “We cannot subsidize Hollywood on the backs of our schoolchildren.”

At the end of an unnecessarily contentious session, nobody had gotten much done.

Rep. Moe Maestas, D-Albuquerque, said, “She views us as the enemy; she does not view us as partners in a democratic government.”

Martinez never changed her approach. For eight years, as I wrote in many a column, she entered sessions with her dukes up. New Mexico paid for this standoff with a slower economic recovery from the Great Recession.

This summer, we regressed a decade. Gov. Michelle Lujan Grisham called a special session on public safety and tried to browbeat lawmakers into approving a set of bills that weren’t ready for prime time. Once again, browbeating by one branch of government didn’t work on another branch. Lujan Grisham not only damaged relations with legislators but made them look bad during campaign season. They won’t forget that.

Lujan Grisham began talking about a special session in March and circulated draft bills, but drafts kept changing. Days ahead of the session lawmakers hadn’t seen completed bills, and the governor was still adding new bills to the call. Two bills were so complex that haphazard approval guaranteed lawsuits. Leaders said repeatedly there was no consensus.

The governor blew past legislators’ concerns and blamed them for not taking crime seriously years ago. “Shame on you,” she said. When 45 advocacy groups and experts objected to problematic legislation, she said taking their advice would be “doing nothing.”

Republicans have demonized Lujan Grisham since she set foot in the Roundhouse, but happily entered the Democrats’ breach by carrying her bills with a few of their own. On July 18, their 16 bills went unheard. In a five-hour session, lawmakers passed the feed bill, which pays for the session, and tacked on fire and flood money for Ruidoso and behavioral health programs.

House Minority Leader Rod Montoya, always ready with his own spin, told New Mexico Political Report: “Republicans agreed with the governor that crime is out of control. It’s unfortunate we’re unable to address anything crime related. The only things my colleagues are willing to do is spend more money.”

Lujan Grisham blistered the Democrats in a red-hot written statement from the governor’s office: “This legislature just demonstrated that it has no interest in making New Mexico safer… (Ignoring the reality of daily crime) is nothing less than a dereliction of duty.

“The legislature as a body walked away from their most important responsibility: keeping New Mexicans safe. But it is noteworthy that a majority of Republicans would have passed many or all of these bills -- they were blocked.

“The legislature should be embarrassed at their inability to summon even an ounce of courage to adopt common-sense legislation… (T)he public should be outraged.”

That’s extreme language. New Mexico In Depth was the only media outlet to call out the governor, saying the entire episode “demonstrates a sharp degree of hubris.”

Or pigheadedness, I would add.

Her language also smacks of campaigning. The last sentence of the public statement was: “My promise to you is that I will not stop fighting to protect you and your families.”

It was something Susana Martinez could have said. The word “fighting” requires an adversary, and Lujan Grisham just made that adversary her own party.

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