Studies suggest that nearly 50% of Bernalillo County residents needing mental health or addiction treatment services are not getting the help they need because of gaps in New Mexico’s behavioral health care. Untreated behavioral health conditions have led to increased and sometimes tragic interactions with law enforcement, over incarceration, overuse of hospital emergency and inpatient services, and unnecessary suffering on the part of patients and their families.
“SHE WHO SHALL NOT BE NAMED”
It should come as absolutely no surprise that behavioral health services in New Mexico are limited. Bernalillo County residents can give a big thanks and shout out to our former Republican Governor “She Who Shall Not Be Named” who was in office for a full 8 years and who almost single handedly destroyed New Mexico’s behavioral health care system. The single cruelest thing that former Republican Governor “She Who Shall Not Be Named” did was when she ordered an “audit” of mental health services provided by nonprofits in New Mexico. She did so based on questionable information. The audit eventually devastated New Mexico’s behavioral health care system.
In June 2013, under the direction of the former Republican Governor, the Human Services Department (HSD) cut off Medicaid funding to 15 behavioral health nonprofits. In 2014, more than 160,000 New Mexicans received behavioral health services, with most of those services funded by Medicaid. After the audits were completed, the former Republican Administration said that the outside audit showed more than $36 million in over billing, as well as mismanagement and possible fraud.
In early 2016, following exhaustive investigations, Attorney General Hector Balderas cleared all 15 of the healthcare providers of any wrongdoing and exonerated all of them of fraud. Even though the New Mexico Attorney General found no fraud and cleared the nonprofits of fraud, the damage had been done to the nonprofits. With the Medicaid funding freeze, many of the 15 nonprofits could not continue and just went out of business leaving many patients without a behavioral health service.
After a full 5 years, the behavioral health care system has made some progress in being restored.
BERNALILLO COUNTY BEVHAVIORAL HEALTH TAX FOR SERVICES
On February 26, 2015, the Bernalillo County Commission approved a 1/8% gross receipts tax increase on a 3-2 vote to fund new behavioral and mental health services to improve access to mental and behavioral health care services in the county. The tax generates approximately $20 million annually.
When enacted, the county commission announced the intent for the tax was to invest the funding “in proven ways to better manage the high cost of addiction, homelessness and mental health problems”. According to a county commission announcement, “these issues impact families throughout the community and drive up the cost of public services, especially at the Metropolitan Detention Center.” The gross receipts tax costs shoppers one cent on a $10 purchase of goods and services.
The 1/8th% gross receipts tax was enacted to be used for the purpose of providing more mental and behavioral health services for adults and children in the Albuquerque and Bernalillo County area. The intent is to provide a safety net system for those in need of mental health not otherwise funded in New Mexico.
In 2015 when the Bernalillo County Commission approved the tax, it failed to develop a plan on how all the money would be used, including not identifying services to be provides, location of facilities and qualifiers to obtain the services offered. As a result of having no spending plan or identifying priorities, the tax was collected but not spent. Since enactment of the tax in 2015, the tax has generated $91.6 million. Bernalillo County approved $20 million toward Behavioral Health Initiative projects with $70 million in tax revenue having accumulated but not spent. But that began to change.
The county has earmarked the bulk of what it has amassed for one-time expenditures. Those expenditures include $30 million for a new crisis triage center, $12 million for supportive housing and $4 million for the Bernalillo County CARE campus, formerly known as the Metropolitan Assessment and Treatment Services center, or MATS. The renovations to the CARE campus when complete will create an outpatient behavioral health clinic and living room space for peer-to-peer counseling sessions.
NEW SYTEM TO AWARD FUNDING
The Bernalillo County Commission established the Behavioral Health Initiative representing a significant step forward in local efforts toward addressing and preventing the mental health, substance abuse, addiction, and homelessness crisis in Albuquerque/Bernalillo County and the middle Rio Grande region of New Mexico.
In November, 2019, County Manager Julie Morgas Baca asked the Bernalillo County Commission to approve a resolution that permits “stakeholders, providers, community members, staff, commissioners, or other interested parties” to propose behavioral health service ideas through a website. Up until now, only county staff had been authorized to propose behavioral health service ideas. All program appropriations will require final approval of the County Commission.
According to Bernalillo County Manager Morgas Baca:
“I just really think it needs to be opened up, and we need to realize there’s a lot of people out there who have real life experience. … I want to solicit their input to see how much of a difference we can make in addition to what we’re already doing.”
On Tuesday, November 12, the resolution passed by a 5-0 vote unanimous vote.
In November, 2019, the Bernalillo County Commission approved a resolution that permits “stakeholders, providers, community members, staff, commissioners, or other interested parties” to propose behavioral health service ideas through a website. Up until then, only county staff had been authorized to propose behavioral health service ideas. All program appropriations are required final approval of the County Commission.
Under the new ordinance passed, each idea from stakeholders, providers, community members, staff and commissioners will go through a vetting process. A county commission appointed committee ensures each proposal meets the criteria for an expenditure based on the behavioral health tax language approved by voters. A separate subcommittee of stakeholders and subject matter experts will also review the idea and recommend the next steps.
Links to news sources are here:
$10 MILLION AWARDED
On Oct. 15, 2019 he Bernalillo County Commissioners (BCC) voted and approved funding of up to $10 Million out of the behavioral health tax. The county typically awards contracts based on established areas of focus. In the past, priorities have included mobile crisis teams and programming for at-risk youth. The new funding approach of asking community input is much less narrowly defined. County officials said that a total of 47 providers ultimately submitted proposals. The county is funding 11 of the private providers at varying amounts by contract lasting up to 3 years.
On December 9, 2020, the Bernalillo County Manager Julie Morgas Baca announced the award of the $10 million allocation to help support local providers for capital, startup, and expansions of behavioral health services. According to a news release:
“This allocation of funding will provide an opportunity for behavioral health providers to expand or develop services that are not otherwise funded and address a gap in the behavioral health continuum. Funds will be available for up to three years and are non-recurring after that time. These programs will be closely monitored by the Department of Behavioral Health Services and aim to measure causal relationships between service delivered and short-term and long-term outcomes.”
The expansion of behavioral health services, while also incentivize the providers to create sustainable, effective linkages between service providers and the people they serve, will improve patients’ access to preventative and chronic care services. The creation of these linkages can help develop and support partnerships between organizations that share a common goal of improving the health of the people and the community in which they live. The expansion will also promote improved outcomes for persons living with a behavioral health diagnosis, a more knowledgeable public, and increased referrals to appropriate services.”
Links to the county news release and news report are here:
The $10 million in behavioral tax funding is the very first-time awards have been made to private providers since the county called on local providers to identify and offer services that are needed in the behavioral health care system.
The 11 providers sharing the $10 million award include:
A New Day
Children’s Grief Center
Crossroads for Women
Endorphin Power Company
First Nations Community
Los Puentes Charter School
NM Veterans Integration Center
Recovery Services of New Mexico
According to executive director Jade Richardson Bock for The Children’s Grief Center of New Mexico, the funding wll be used to:
“expand even further and to meet the demand caused by the COVID pandemic, caused by overdoses, DWI deaths, cancer, heart attack (and) all of the tragic causes of death that affect our citizens.”
Crossroads for Women, which provides housing and other support to formerly incarcerated women, will buy a new property to accommodate its growing programs.
ARCA will use its money to help clients recovering from an acquired brain injury, any type of brain damage that happens after birth from a wide variety of causes. The money will go toward a planned intake and assessment facility that the nonprofit’s leaders say will help bridge the gap between acute injury care and the possible return to independent living. The center will include bedrooms for temporary stays, therapy areas and more, said Michele Cody, ARCA’s chief development officer.
ENDORPHIN POWER COMPANY
The Endorphin Power Company (EPC) outlay of $195,000 of the behavioral health tax is very noteworthy of the awards in that the allocation essentially embodies the spirit, purpose and intent of the behavioral tax. The mission statement of the Endorphin Power Company says it best:
“To provide single occupancy, transitional housing for people experiencing homelessness as a result of substance abuse. [It provides] a safe, clean and sober living environment where people become part of a healthy community and are encouraged to set and reach goals. The Endorphin Power Company see substance abuse and homelessness as both an individual and social problem. [The] goal is to address that problem on both levels at once. We want to contribute to the greater good of local and global communities by promoting the benefits of healthy-living, healthy connections and environmental consciousness. We seek to cultivate an environment in which individuals and communities foster health, happiness, and awareness through the “Four Pillars” of education, exercise, community and service to others.”
EPC is arguably the most sought-after transitional living facility in New Mexico. It offers a very unique program designed to help individuals dealing with addiction and homelessness. The EPC program also offers intensive case management and therapy for those in need of it and want it without being forced. EPC also operates a community center, fitness center and a step-down housing triplex to help clients with their transition process while also building a rental history (if necessary).
EPC has operated out of an old church located at 509 Cardenas Dr, SE, in Albuquerque’s International District, but that is about to change. Executive Director Jeffrey Holland announced a $3 million new facility at the location. EPC will demolish its “community building” and build a new facility that will offer a place for its live-in clients to get everything they need, from counseling to social support to physical fitness programs in one place, while also further extending its reach into the larger community. According to Holland, people who do not live on the premises there could come to see therapists and attend support group meetings or simply walk in from the street for help navigating the city’s larger social services landscape.
Executive Director Jeffrey Holland had this to say:
“[The Endorphin Power Company is in] a high need area … We want to reimagine the idea of a communal building. … We all know what ‘community centers’ look like, with basketball courts and that stuff, but have we ever thought of an idea of a ‘community services’ building?”
COMMENTARY AND ANALYIS
Although it took a little over a full year to allocate and distribute the $10 Million in accumulated funding of behavioral tax revenues, the long wait was worth it and so was the process. When Bernalillo County announced the new process to award funding, it generated an exceptional amount of interest from mental health care providers throughout the city. When the county held its first meeting to explain the proposal process, so many people showed up to the hearing room that the fire marshal had to be called to intervene. The county proceeded to reschedule the meeting for a later date and held the meeting at a larger venue.
Despite the pandemic, 47 providers ultimately submitted proposals to the County all of which had to be reviewed and analyzed. This is how government is supposed to work. Bernalillo County Government and taxpayers can take great comfort to know that the county is indeed spending the behavioral health tax on programs that will reach those that are in need of it the most.