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F I S C A L I M P A C T R E P O R T

SPONSOR Maestas

ORIGINAL DATE

LAST UPDATED

1/21/08

2/11/08 HB 224/aHJC/aHAFC

SHORT TITLE Inmate Opiate Addiction Pilot Project

SB

ANALYST Peery-Galon

ESTIMATED ADDITIONAL OPERATING BUDGET IMPACT (dollars in thousands)

FY08

FY09

FY10 3 Year

Total Cost

Recurring

or Non-Rec

Fund

Affected

Total

$0.1

$0.1

$0.1 Recurring General

Fund

(Parenthesis ( ) Indicate Expenditure Decreases)

SOURCES OF INFORMATION

LFC Files

Responses Received From

Commission on the Status of Women

Human Services Department (HSD)

Department of Health (DOH)

No Responses Received From

Adult Parole Board

New Mexico Corrections Department

SUMMARY

Synopsis of House Appropriations and Finance Committee Amendment

HAFC amendment of House Bill 224 strikes all language pertaining to the making of an

appropriation. The amendment clarifies that a maximum of 50 females will participate in the

opiate addiction treatment for inmates pilot project and that the pilot project is subject to the

availability of funds. Also, the amendment strikes language pertaining to the pilot project

running from July 1, 2008 to June 30, 2010.

Synopsis of House Judiciary Committee Amendment

HJC amendment of House Bill 224 on page 2, line 22, after “the" inserts “human services" and

strikes “of health"; on page 3, line 2, after “the" inserts “human services and strikes “of health";

on page 3, line 12, before “department" inserts “human services" and strikes “of health"; and on

page 3, line 21, before “department" inserts “human services" and strikes “of health".

House Bill 224/aHJC/aHAFC – Page 2

The amendment changes the language of the original bill and assigns administrative, contracting

and evaluation oversight for the Opiate Addiction Treatment for Inmates Pilot Project to the

Human Services Department, in collaboration with the New Mexico Corrections Department,

rather than the Department of Health.

Synopsis of Original Bill

House Bill 224 appropriates $250.0 from the general fund to the Department of Health to create

opiate addiction treatment for inmates pilot project. A two-year pilot project that provides opiate

addiction treatment, utilizing buprenorphine/naloxone, to 50 women with a history of heroin or

other opiate addition who are incarcerated and soon to be released on parole from the New

Mexico Women’s Correctional Facility and Camino Nuevo Correctional Center. Priority is to be

given to those women who are closest to being released from incarceration and to those planning

to parole to a community within 60 miles of a physician certified to prescribe

buprenorphine/naloxone therapy. The Department of Health is to collaborate with the New

Mexico Corrections Department to administer and evaluate the pilot project and to contract for

the services of buprenorphine/naloxone-certified physicians and case managers to evaluate and

treat the women participants. Women in the pilot project will be compared to women with a

history of opiate addiction who are not treated with buprenorphine/naloxone. The evaluation is

to include findings about recidivism, relapse, cost savings, change in physical and mental health

status, employment status, parenting and other quality of life indicators during the project period.

The Department of Health and New Mexico Corrections Department is to report independently

to the appropriate interim legislative committee on the evaluations, treatments and outcomes of

the pilot project participants by December 1, 2009 and again by December 1, 2010.

FISCAL IMPLICATIONS

The appropriation of $250.0 contained in this bill is a recurring expense to the general fund. Any

unexpended or unencumbered balance remaining at the end of fiscal year 2010 shall revert to the

general fund.

HSD reports Medicaid currently does not pay for outpatient substance abuse treatment.

However, some services under this project, such as counseling and comprehensive community

support, are covered by Medicaid. Any behavioral health services provided to Medicaid-eligible

individuals would be eligible for federal match if all the following criteria are met: the service

must be a benefit under the New Mexico Medicaid State Plan, the provider must be credentialed

as a Medicaid provider as part of the ValueOptions New Mexico provider network, and the

provider is providing services in accordance with his or her license.

HSD and DOH both report incarceration in New Mexico costs around $100 a day per person.

HSD and DOH both state that female recidivists alone, repeating crimes and returning to prison

for narcotic-related activities, cost New Mexican taxpayers nearly $3 million per year.

DOH states a program of this magnitude may require further funding to ensure sustainability and

continued supportive services and engagement with pilot project participants beyond the two-

year mandate.

House Bill 224/aHJC/aHAFC – Page 3

SIGNIFICANT ISSUES

DOH reports the House Judiciary Committee amendment of House Bill 224 would require

collaboration between the Human Services Department, instead of the Department of Health, and

the New Mexico Corrections Department to implement a two-year buprenorphine treatment pilot

for 50 women prisoners with a history of opiate addition, who are within two months of their

release date.

NMCD states the House Judiciary Committee amendment of House Bill 224 appropriates $250

thousand to the Human Services Department for use in fiscal years 2009 and 2010 so that the

department can collaborate with the Corrections Department to administer a two-year pilot study

project that provides opiate replacement treatment to 50 women incarcerated in or paroled from

the Camino Nuevo correctional facility and the New Mexico Women’s Correctional Facility.

HSD reports 75 percent of women who go to prison for the first time for narcotic-related crimes

will re-offend and return to prison within 2.5 years. The Buprenorphine Pilot Project is an

inmate treatment program that would provide the first medical intervention to break the cycle of

criminal activities that occur to support drug addition.

HSD reports Buprenorphine is a Drug Enforcement Agency approved daily oral medication that,

when combined with Naloxone, effectively blocks the action of heroin and other narcotics. It is

an extremely safe medication that is used in community-based narcotic treatment programs.

HSD states the availability of the medication means that women returning to their communities

can continue treatment, which significantly reduces the opportunities for relapse and/or

overdose.

DOH reports that opiate addition in New Mexico is associated with high rates of morbidity and

mortality. In 2007, New Mexico ranked third in the United States in per-capita overdose deaths.

DOH notes that 85 percent of incarcerated women in New Mexico have a history of addiction

and 40 percent have a history of injection drug use.

PERFORMANCE IMPLICATIONS

HSD reports the goal of the Behavioral Health Collaborative Strategic Plan is to reduce the

adverse effects of substance abuse through services that are recovery-oriented, culturally

competent, and responsive to the needs of those who receive them, including high-risk

individuals and populations.

DOH notes that the proposed legislation aligns with its objective to decrease the transmission of

infectious disease cases and expand services for persons with infectious diseases.

ADMINISTRATIVE IMPLICATIONS

DOH states the proposed legislation would create additional workload and would require

additional staffing. DOH notes the case management component in the proposed legislation

could be implemented by the department or a proxy to ensure best practices in the provision of

services.

House Bill 224/aHJC/aHAFC – Page 4

OTHER SUBSTANTIVE ISSUES

DOH notes that Hispanics in New Mexico represent the majority of heroin users enrolled in the

department’s syringe exchange program and Hispanic women represent the majority of women

incarcerated for drug-related crimes.

HSD and DOH notes of the around 600 women incarcerated in the New Mexico Women’s

Correctional Facility alone collectively leave behind 1,800 dependent children under the age of

18.

ALTERNATIVES

HSD states the appropriation, as written would be made to Department of Health, may be more

appropriate going to the Human Services Department for administration by its Behavioral Health

Services Division.

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