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With GOP healthcare bill, New Mexico may lose funding for addiction treatment

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SANTA FE, N.M. (AP) — New Mexico stands to lose critical funding for substance abuse treatment that has helped combat a local opioid epidemic, under a Republican campaign on Capitol Hill to roll back President Barack Obama’s health care law.

A House-approved health care bill would phase out expanded Medicaid that allows states to provide federally backed insurance to low-income adults. Federal Medicaid expansion dollars have allowed key states to boost their response to the opioid crisis, paying for medication, counseling, therapy and other services.

In New Mexico, the expansion accounted for 21 percent of Medicaid spending on behavioral health — a category that includes mental health and substance abuse — in the year ending in June 2016.

The state Human Services Department says that translates into $101 million out of $477 million in behavioral health spending. Numbers specific to addiction treatment were not available.

State officials estimate that behavioral health services have been extended to reach 75 percent more people since Medicaid was expanded at the start of 2014.

In 2014, New Mexico had the second-highest overdose death rate behind West Virginia, according to the federal Centers for Disease Control and Prevention. In 2015, seven other states had higher overdose rates.
Wayne Lindstrom, director of the New Mexico Behavioral Health Services Division at the state agency overseeing Medicaid programs, predicted a major setback for substance abuse treatment and other behavioral health programs if Republicans do away with the federal Medicaid expansion funding.
“It concerns me with all of the discussion going on in Washington, potentially block granting Medicaid, potentially doing away with Medicaid expansion, because this would be devastating for the behavior health field,” he told a panel of state lawmakers this month. “If Medicaid is significantly dismantled and there are significant cutbacks, it’s going to have huge ramifications for us.”

New Mexico’s annual state budget includes an escape clause allowing the state to rescind Medicaid eligibility for adults if federal support for the expansion is rolled back.

New Mexico state Sen. Gerald Ortiz y Pino, D-Albuquerque, said he fears treatment for substance abuse would be among the first services to be eliminated by the state if federal aid is rolled back.

“A lot of those services are not mandatory. We don’t have them in state law or federal law,” he said Tuesday. “Those tend to get short shrift if we have to cut back. I think they might be the first things to go.”

New Mexico’s delegation to Washington is divided along partisan lines over the GOP health care overhaul, with Democratic Sens. Tom Udall and Martin Heinrich on Tuesday describing potentially devastating consequences.

Republican U.S. Rep. Steve Pearce, who voted for the House bill, said expansion funding would decrease only for people who drop Medicaid coverage and then return. “Individuals impacted by opioid addiction, and everyone else who gained coverage under Medicaid expansion, will continue to receive care as long as they stay on the program,” he said in an email.

Jonathan Willoughby, a staff therapist at a for-profit, Medicaid-supported center in Albuquerque that treats court-ordered patients for substance abuse problems, said staff and patients confront an uncertain future. “Most if not all our clients would end up incarcerated again” if the program were defunded, he said.

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‘For fun’ killing reveals vulnerability for homeless Native Americans in New Mexico

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The morning a homeless man was shot and killed in Albuquerque, police say surveillance videos showed him running down a street before sunrise, and then gunfire flash in the dark.

Native Americans make up only 4 percent of the population, but account for 44 percent of people living on the streets, raising the likelihood they will be victimized when there is an attack on the homeless.

Ronnie Ross, a 50-year-old from the Navajo Nation town of Shiprock, had been shot a dozen times, including once in the forehead and temple, and four times in the back, according to a criminal complaint. Police say the two teenage suspects charged with murder this week apparently shot him “for fun” as they came and went from a hotel party nearby.

The homicide marked the latest in a series of brazen killings and assaults of homeless Native Americans in the city. In Albuquerque, Native Americans make up only 4 percent of the population, but account for 44 percent of people living on the streets, raising the likelihood they will be victimized when there is an attack on the homeless.

A 2014 survey showed 75 percent of homeless Native Americans in Albuquerque had been physically assaulted.

“Just being harassed is part of everyday life, but it’s not as much harassment as it is overgrown bullying,” said Gordon Yawakia, who works at the Albuquerque Indian Center and was once homeless himself. “What do you do when people are against you and then the authorities are against you and you’ve got nobody, you know?”

In 2014, Allison Gorman and Kee Thompson, both Navajo, were beaten to death as they slept in a vacant lot. While authorities did not say the men were targeted because they were Native American, activists disagreed and the deaths spurred the creation of a city task force to address Native American homelessness that now-former Mayor Richard Berry said could set the stage for changes for the population across the Southwest.

Now, Ross’ death is underscoring how difficult it may be to protect and find solutions for the city’s Native American homeless population.

“When I hear a story like this it adds fuel to the fire,” said Dawn Begay, who is the city’s tribal liaison, and works with the homeless through a local nonprofit. “Where we’re headed is a good direction but it has to happen faster.”

Ross’ killing in March came three months after the body of Audra Willis was found decapitated in an area not far from the Sandia Mountains that line the city’s east side. The 39-year-old had come from To’hajiilee, a tiny Navajo community west of Albuquerque, and records show she had multiple addresses during her time in the city, including at the Albuquerque Indian Center.

Willis’ especially grisly death sent shockwaves through Albuquerque, just as the beatings of Thompson and Gorman had three years earlier.

The two men had been killed on a July 2014 night when authorities say three boys — ages 15, 16 and 18_returned home from a night of drinking and decided to attack them as they slept on a mattress. The men were beaten with a wooden table leg, cinder blocks, and other objects, police said. One young suspect later told authorities that the teens had beaten dozens of homeless people, though apparently none others fatally.

In Ross’ death, the complaint filed against the 15- and 17-year-old suspects does not identify a motive, but says the two teenagers bragged to friends about the shooting.

According to police, friends and acquaintances of the boys — whom The Associated Press is not naming because of their ages — said the suspects had been showing off a gun at the party, and had said to others that they had shot a man. At one point, the younger boy also said to a close friend at the party that he shot a “hobo” in the back.

The boys made one more stop at the scene to find Ross still alive, prompting the older boy to shoot him multiple times, according to the complaint.

“It’s completely disturbing,” said Officer Simon Drobik, an Albuquerque police spokesman, said Tuesday. “They just shot this guy for fun.”

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The Last Castro; Raul retires as Cuban president

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Raul Castro turned over Cuba’s presidency Thursday to a 57-year-old successor he said would hold power until 2031, a plan that would place the state the Castro brothers founded and ruled for 60 years in the hands of a Communist Party official little known to most on the island.

Castro’s 90-minute valedictory speech offered his first clear vision for the nation’s future power structure under new President Miguel Mario Diaz-Canel Bermudez. Castro said he foresees the white-haired electronics engineer serving two five-year terms as leader of the Cuban government, and taking the helm of the Communist Party, the country’s ultimate authority, when Castro leaves the powerful position in 2021.

“From that point on, I will be just another soldier defending this revolution,” Castro said. The 86-year-old general broke frequently from his prepared remarks to joke and banter with officials on the dais in the National Assembly, saying he looked forward to having more time to travel the country.

In his own half-hour speech to the nation, Diaz-Canel pledged to preserve Cuba’s communist system while gradually reforming the economy and making the government more responsive to the people.

“There’s no space here for a transition that ignores or destroys the legacy of so many years of struggle,” Diaz-Canel said. “For us, it’s totally clear that only the Communist Party of Cuba, the guiding force of society and the state, guarantees the unity of the nation of Cuba.”

Diaz-Canel said he would work to implement a long-term plan laid out by the National Assembly and communist party that would continue allowing the limited growth of private enterprises like restaurants and taxis, while leaving the economy’s most important sectors such as energy, mining, telecommunications, medical services and rum- and cigar-production in the hands of the state.

“The people have given this assembly the mandate to provide continuity to the Cuban Revolution during a crucial, historic moment that will be defined by all that we achieve in the advance of the modernization of our social and economic model,” Diaz-Canel said.

Cubans said they expected their new president to deliver improvements to the island’s economy, which remains stagnant and dominated by inefficient, unproductive state-run enterprises that are unable to provide salaries high enough to cover basic needs. The average monthly pay for state workers is roughly $30 a month, forcing many to steal from their workplaces and depend on remittances from relatives abroad.

“I hope that Diaz-Canel brings prosperity,” said Richard Perez, a souvenir salesman in Old Havana. “I want to see changes, above all economic changes allowing people to have their own businesses, without the state in charge of so many things.”

But in Miami, Cuban-Americans said they didn’t expect much from Diaz-Canel.

“It’s a cosmetic change,” said Wilfredo Allen, a 66-year-old lawyer who left Cuba two years after the Castros’ 1959 revolution. “The reality is that Raul Castro is still controlling the Communist Party. We are very far from having a democratic Cuba.”

After formally taking over from his older brother Fidel in 2008, Raul Castro launched a series of reforms that led to a rapid expansion of Cuba’s private sector and burgeoning use of cellphones and the internet. Cuba today has a vibrant real estate market and one of the world’s fastest-growing airports. Tourism numbers have more than doubled since Castro and President Barack Obama re-established diplomatic relations in 2015, making Cuba a destination for nearly 5 million visitors a year, despite a plunge in relations under the Trump administration.

Castro’s moves to open the economy even further have largely been frozen or reversed as soon as they began to generate conspicuous displays of wealth by the new entrepreneurial class in a country officially dedicated to equality among its citizens. Foreign investment remains anemic and the island’s infrastructure is falling deeper into disrepair. The election of President Donald Trump dashed dreams of detente with the U.S., and after two decades of getting Venezuelan subsidies totaling more than $6 billion a year, Cuba’s patron has collapsed economically, with no replacement in the wings.

Castro’s inability or unwillingness to fix Cuba’s structural problems with deep and wide-ranging reforms has many wondering how a successor without Castro’s founding-father credentials will manage the country over the next five or 10 years.

“I want the country to advance,” said Susel Calzado, a 61-year-old economics professor. “We already have a plan laid out.”

Most Cubans have known their new president as an uncharismatic figure who until recently maintained a public profile so low it was virtually nonexistent. Castro’s declaration Thursday that he saw Diaz-Canel in power for more than a decade was likely to resolve much of the uncertainty about the power the new president would wield inside the Cuban system.

“The same thing we’re doing with him, he’ll have to do with his successor,” Castro said. “When his 10 years of service as president of the Council of State and Council of Ministers are over, he’ll have three years as first secretary in order to facilitate the transition. This will help us avoid mistakes by his successor, until (Diaz-Canel) retires to take care of the grandchildren he will have then, if he doesn’t have them already, or his great-grandchildren.”

Cuban state media said Russian President Vladimir Putin congratulated Diaz-Canel and thanked Castro for the many years of cooperation between the two countries, while Chinese President Xi Jinping also reaffirmed his country’s friendship with Cuba and expressed interest in deeper ties.

At the U.S. State Department, spokeswoman Heather Nauert expressed disappointment at the handover, saying Cuban citizens “had no real power to affect the outcome” of what she called the “undemocratic transition” that brought Diaz-Canal to the presidency.

Vice President Mike Pence tweeted at Castro that the U.S. won’t rest until Cuba “has free & fair elections, political prisoners are released & the people of Cuba are finally free!”

Diaz-Canel said his government would be willing to talk with the United States but rejected all demands for changes in the Cuban system.

With Castro watching from the audience, Diaz-Canel made clear that for the moment he would defer to the man who founded the Cuban communist system along with his brother Fidel. He said he would retain Castro’s cabinet through at least July, when the National Assembly meets again.

“I confirm to this assembly that Raul Castro, as first secretary of the Communist Party, will lead the decisions about the future of the country,” Diaz-Canel said. “Cuba needs him, providing ideas and proposals for the revolutionary cause, orienting and alerting us about any error or deficiency, teaching us, and always ready to confront imperialism.”

Diaz-Canel first gained prominence in central Villa Clara province as the top Communist Party official, a post equivalent to governor. People there describe him as a hard-working, modest-living technocrat dedicated to improving public services. He became higher education minister in 2009 before moving into the vice presidency.

In a video of a Communist Party meeting that inexplicably leaked to the public last year, Diaz-Canel expressed a series of orthodox positions that included somberly pledging to shutter some independent media and labeling some European embassies as outposts of foreign subversion.

But he has also defended academics and bloggers who became targets of hard-liners, leading some to describe him a potential advocate for greater openness in a system intolerant of virtually any criticism or dissent. International observers and Cubans alike will be scrutinizing every move he makes in coming days and weeks.

As in Cuba’s legislative elections, all of the leaders selected Wednesday were picked by a government-appointed commission. Ballots offered only the option of approval or disapproval and candidates generally receive more than 95 percent of the votes in their favor. Diaz-Canel was approved by 604 votes in the 605-member assembly. It was unclear if he had abstained or someone else had declined to endorse him.

The assembly also approved another six vice presidents of the Council of State, Cuba’s highest government body. Only one, 85-year-old Ramiro Valdes, was among the revolutionaries who fought with the Castros in the late 1950s in the eastern Sierra Maestra mountains.

___

Associated Press writer Ben Fox contributed to this report.

 

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Cuba without Castro – New President provides a glimpse on the island’s future

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Miguel Diaz-Canel has been the presumptive next president of Cuba since 2013, when Raul Castro named the laconic former provincial official to the important post of first vice president and lauded him as “neither a novice nor an improviser,” high praise in a system dedicated to continuity over all.

Castro said nothing about how a young civilian from outside his family could lead the socialist nation that he and his older brother Fidel created from scratch and ruled with total control for nearly 60 years.

Exiles in Miami said Diaz-Canel would be a figurehead for continued Castro dominance. Cubans on the island speculated about a weak president sharing power with the head of the communist party, or maybe a newly created post of prime minister. No one who knew was talking. And no one who was talking knew.

The first clues to the mystery of Cuba’s future power structure were revealed early Thursday when Raul Castro handed the presidency to Diaz-Canel, who took office when the 604-member National Assembly said 603 of its members had approved the 57-year-old as the sole official candidate for the top government position.

With Castro watching from the audience, Diaz-Canel made clear that for the moment he would defer to the man who founded Cuba’s communist system along with his brother. Diaz-Canel said he would retain Castro’s Cabinet through at least July, when the National Assembly meets again.

“I confirm to this assembly that Raul Castro, as first secretary of the Communist Party, will lead the decisions about the future of the country,” Diaz-Canel said. “Cuba needs him, providing ideas and proposals for the revolutionary cause, orienting and alerting us about any error or deficiency, teaching us, and always ready to confront imperialism.”

Perhaps more importantly, Castro’s 90-minute valedictory speech offered his first clear plan for a president whom Castro seemed to envision as the heir to near-total control of the country’s political system, which in turn dominates virtually every aspect of life in Cuba. Castro said he foresees the white-haired electronics engineer serving two five-year terms as leader of the Cuban government, and taking the helm of the Communist Party, the country’s ultimate authority, also for two five-year terms, when Castro leaves the powerful position in 2021.

“From that point on, I will be just another soldier defending this revolution,” Castro said. The 86-year-old general broke frequently from his prepared remarks to joke and banter with officials on the dais in the National Assembly, saying he looked forward to having more time to travel the country.

State media struck a similar valedictory tone. The evening newscast played black-and-white footage of Castro as a young revolutionary, with the soundtrack of “The Last Mambi” a song that bids farewell to Castro as a public figure and was written by Raul Torres, a singer who composed a similar homage to Fidel Castro after the revolutionary leader’s death in 2016.

The plan laid out by Raul Castro on Thursday would leave Diaz-Canel as the dominant figure in Cuban politics until 2031.

“The same thing we’re doing with him, he’ll have to do with his successor,” Castro said. “When his 10 years of service as president of the Council of State and Council of Ministers are over, he’ll have three years as first secretary in order to facilitate the transition. This will help us avoid mistakes by his successor, until (Diaz-Canel) retires to take care of the grandchildren he will have then, if he doesn’t have them already, or his great-grandchildren.”

Diaz-Canel pledged that his priority would be preserving Cuba’s communist system while gradually reforming the economy and making the government more responsive to the people.

“There’s no space here for a transition that ignores or destroys the legacy of so many years of struggle,” Diaz-Canel said.

Diaz-Canel said he would work to implement a long-term plan laid out by the National Assembly and Communist Party that would continue allowing the limited growth of private enterprises like restaurants and taxis, while leaving the economy’s most important sectors such as energy, mining, telecommunications, medical services and rum- and cigar-production in the hands of the state.

“The people have given this assembly the mandate to provide continuity to the Cuban Revolution during a crucial, historic moment that will be defined by all that we achieve in the advance of the modernization of our social and economic model,” Diaz-Canel said.

Cubans said they expected their new president to deliver improvements to the island’s economy, which remains stagnant and dominated by inefficient, unproductive state-run enterprises that are unable to provide salaries high enough to cover basic needs. The average monthly pay for state workers is roughly $30 a month.

“I hope that Diaz-Canel brings prosperity,” said Richard Perez, a souvenir salesman in Old Havana. “I want to see changes, above all economic changes allowing people to have their own businesses, without the state in charge of so many things.”

But in Miami, Cuban-Americans said they didn’t expect much from Diaz-Canel.

“It’s a cosmetic change,” said Wilfredo Allen, a 66-year-old lawyer who left Cuba two years after the Castros’ 1959 revolution. “The reality is that Raul Castro is still controlling the Communist Party. We are very far from having a democratic Cuba.”

After formally taking over from his older brother Fidel in 2008, Raul Castro launched a series of reforms that led to a rapid expansion of Cuba’s private sector and burgeoning use of cellphones and the internet. Cuba today has a vibrant real estate market and one of the world’s fastest-growing airports. Tourism numbers have more than doubled since Castro and President Barack Obama re-established diplomatic relations in 2015, making Cuba a destination for nearly 5 million visitors a year, despite a plunge in relations under the Trump administration.

Castro’s moves to open the economy even further have largely been frozen or reversed as soon as they began to generate conspicuous displays of wealth by the new entrepreneurial class in a country officially dedicated to equality among its citizens. Foreign investment remains anemic and the island’s infrastructure is falling deeper into disrepair. The election of President Donald Trump dashed dreams of detente with the U.S., and after two decades of getting Venezuelan subsidies totaling more than $6 billion a year, Cuba’s patron has collapsed economically, with no replacement in the wings.

Castro’s inability or unwillingness to fix Cuba’s structural problems with deep and wide-ranging reforms has many wondering how a successor without Castro’s founding-father credentials will manage the country over the next five or 10 years.

“I want the country to advance,” said Susel Calzado, a 61-year-old economics professor. “We already have a plan laid out.”

At the U.S. State Department, spokeswoman Heather Nauert expressed disappointment at the handover, saying Cuban citizens “had no real power to affect the outcome” of what she called the “undemocratic transition.”

Vice President Mike Pence tweeted at Castro that the U.S. won’t rest until Cuba “has free & fair elections, political prisoners are released & the people of Cuba are finally free!”

Diaz-Canel first gained prominence in Villa Clara province as the top Communist Party official, a post equivalent to governor. People there describe him as a hard-working, modest-living technocrat dedicated to improving public services. He became higher education minister in 2009 before moving into the vice presidency.

In a video of a Communist Party meeting that inexplicably leaked to the public last year, Diaz-Canel expressed a series of orthodox positions that included somberly pledging to shutter some independent media and labeling some European embassies as outposts of foreign subversion.

But he has also defended academics and bloggers who became targets of hard-liners, leading some to describe him a potential advocate for greater openness in a system intolerant of virtually any criticism or dissent.

International observers and Cubans alike will be scrutinizing every move he makes in coming days and weeks.

___

Associated Press writer Ben Fox contributed to this report.

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