SANTA FE - New Mexico should cap the number of low-income people who can qualify for health aides who assist with cooking, cleaning and, in certain cases, bathing and feeding, according to a new legislative report.

Since 2009, the budget for the state's Coordination of Long-Term Services (CoLTS) program has ballooned, from $448 million to a projected $850 million this year, says the Legislature's budget arm, the Legislative Finance Committee.

And a major reason is the over-use of personal health aides.

"This has been a primary cost driver," Charles Sallee of the LFC told state lawmakers on Tuesday during a meeting of the Senate Finance Committee.

Last year, $334 million of the more than $750 million spent in the program went toward paying for personal health aides, Sallee said. The majority of the people enrolled in the CoLTS program are over age 50, state officials said. The use of health aides helps to keep individuals out of nursing homes, where medical costs often are higher. Sallee said, however, that some program recipients wracked up higher costs using health aides than the typical nursing home bill.

In addition to capping the number of people who qualify for health aides, the LFC also is recommending limiting the number of hours a week a health aide can work in a home.

In the 2009 budget year, more than 4,400 clients in the program used personal health aides in excess of 30 hours a week, according to the LFC report.

The caps would require a

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waiver from the federal government.

The state Human Services Department (HSD) agrees costs in the CoLTS program are rising, but it disputes why. The tough economy and the number of people entering the long-term services program explains the dramatic cost increases more than the use of personal health aides, Julie Weinberg, interim director of the HSD's Medical Assistance Division, told state lawmakers.

"If you look at our enrollment numbers, we are increasing - our enrollment has gone way up," Weinberg said. "These costs would have existed whether we had CoLTs or not.''

The LFC's focus on the CoLTS program comes after questions have arisen whether it was wise for New Mexico to contract with two managed-care organizations in 2008 to administer the program, which falls under Medicaid. Medicaid is the government's low-income health insurance program.

The LFC's report questioned whether the managed-care organizations - Evercare of New Mexico Inc., a division of United Health Group, and Amerigroup Community Care of New Mexico Inc. - were saving the state much money, which was one of the reasons for going to a managed-care model.

Contact Trip Jennings at (505) 986-3050 or at tjennings@ sfnewmexican.com.