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DATE TYPED: |
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HB |
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SHORT TITLE: |
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SB |
387 |
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ANALYST: |
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APPROPRIATION
Appropriation
Contained |
Estimated
Additional Impact |
Recurring or
Non-Rec |
Fund Affected |
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FY03 |
FY04 |
FY03 |
FY04 |
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$600.0 |
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Recurring |
GF |
$400.0 |
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Recurring |
GF |
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(Parenthesis
( ) Indicate Expenditure Decreases)
Relates to SB49
Relates to Appropriation in the General Appropriation Act
Responses Received From
Department of Health (DOH)
Health Policy Commission (HPC)
Synopsis of Bill
Senate Bill 387 appropriates $600.0 from the
general fund to the Department of Health for expenditure in fiscal years 2003
and 2004 for the purposes of contracting for women’s alcoholism and substance
abuse treatment services based in Velarde in
In addition, SB 387
appropriates $400.0 from the general fund to the Department of Health for
expenditure in fiscal years 2003 and 2004 for the purposes of contracting for a
regional medically supervised best practices alcohol and substance abuse
detoxification program based in the county facility in Velarde in
SB 387 contains an emergency clause.
Significant Issues
Within
Funding
for detoxification and residential beds in
DOH states that SB 387
does not acknowledge the need for collaboration with the existing Regional Care
Coordinator for the region (Region II Behavioral Health Providers, Inc). Detoxification and residential care are
preliminary and intensive modalities of care. It is critical that when a client
has been in residential care and has stabilized, that an immediate focus be on
the recovery process and the implementation of successful recovery
techniques. The next step in treatment
is coordination of an array of services. It is the responsibility of the
Regional Care Coordinator (RCC) to see that continuing coordination takes place
and ensures the most appropriate and cost effective services are provided.
FISCAL IMPLICATIONS
The appropriation of
$1,000.0 contained in this bill is a recurring expense to the general fund.
Any unexpended or
unencumbered balance remaining at the end of fiscal year 2004 shall revert to
the general fund.
In FY03, $7,800.0 was
appropriated for substance abuse for the state.
The Corrections budget received $2,000.0 of that funding. The Northeast
quadrant of the state (Region 2) received $766.7 of those funds. The same funding for these programs is included
in HB2 for FY 04.
ADMINISTRATIVE
IMPLICATIONS
There
would be a moderate impact within DOH; initially considerable effort would have
to be expended to develop a Request For Proposal to follow the process of the
Procurement Code. DOH would have to develop a contract for the designated
recipient and manage the start-up and initial operations. The department could absorb additional management
responsibilities by DOH.
RELATIONSHIP
TECHNICAL ISSUES
From
a clinical perspective, detoxification from alcohol is not the same as
detoxification from opiates or from sedatives or stimulants. Physical
withdrawal and its side effects are different for each of the drugs. Medical
complications during treatment will require special skills.
The naming of a specific community location in
SB387 may deter other service providers in the region, and specifically the
OTHER SUBSTANTIVE
ISSUES
The
Department of Health recognizes and has long been concerned with the high rates
of alcohol and substance use in
SB 387 proposes to
specifically target women and medical detoxification in the newly purchased
county facility in
will provide
7-day detox services.
There is a shortage of intermediate and long-term residential services
available, so Rio Arriba’s facility is expected to
assist with meeting this need.
SB 387 focuses on women’
substance abuse services and detoxification services. One of the major gaps in services in northern
NM is for adolescents. The Department of Health feels that these programs
should include adolescents with these problems and should also be inclusive of
mental health treatment as part of the services provided.
Consideration should
be given to requiring clear written agreements between all the current providers
and programs to ensure that they work collaboratively and cooperatively to
implement these new services. While it is recognized that the needs are great
in
The following
indicators of Substance Abuse are reported from the 1997 New Mexico Social Indicator
Project Report (1995-1997), Oct. 1999 Behavioral Epidemiology and Evaluation
Unit Office of Epidemiology, PHD, NMDOH. In District 2 (NNM), both San Miguel
and
(BHSD) estimates that
$1,000,000 will fund about 36 clients for a 120-day course of treatment. Note
that this sum is to be spread across 2 fiscal years. HPC recommends a
cost-benefit analysis to determine if an
alternative outpatient treatment is more cost effective.
HPC notes that from1995 to 1998 seventy-seven (77) documented deaths have been directly attributed in the county to overdoses of illegal substances. (Source: Rio Arriba Community Health and Justice Technical Assistance Response Team Report –Office of Justice Programs, United States Department of Justice, 1999).
The financial/opportunity-lost cost of addiction and drug
related crime is also significant, particularly for an economically poor area like
HPC points out that there is also agreement that significant
resources are already being spent on drug prevention and treatment programs in
North Central New Mexico and that more money alone will not solve the problem.
The State Department of Health's Region II, the area in which
POSSIBLE QUESTIONS
Would
appropriating the funds in a less prescriptive manner allow DOH the opportunity
to spend these funds in the most cost-efficient manner?
DB/yr