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SPONSOR: |
Salazar |
DATE TYPED: |
3/3/03 |
HB |
767 |
||
SHORT TITLE: |
Long-Term Outpatient Treatment Programs |
SB |
|
||||
|
ANALYST: |
Dunbar |
|||||
APPROPRIATION
Appropriation
Contained |
Estimated
Additional Impact |
Recurring or
Non-Rec |
Fund Affected |
||
FY03 |
FY04 |
FY03 |
FY04 |
|
|
|
$40.0 |
|
|
Recurring |
GF |
|
|
|
|
|
|
(Parenthesis
( ) Indicate Expenditure Decreases)
Relates to SJM10, HB257,
SB387, HB719, SB638.
Responses
Received From
Department
of Health (DOH)
Health
Policy Commission (HPC)
SUMMARY
Synopsis
of Bill
House Bill 767
appropriates $40,000 from the general fund to the Department of Health (DOH) to
support long-term outpatient alcohol and substance abuse treatment programs in
the state.
Significant
Issues
HB
767 supports long-term outpatient alcohol and substance abuse treatment
programs in New Mexico. However, it is not clear what type of support is
intended with the appropriation. This amount
could provide the salary and benefits of one FTE, but it would not be feasible
to fund a single position to support and provide services for different
programs around the state. Support
could also consist of statewide training in long-term outpatient models or the
development of some type of tracking system for recipients of long-term
outpatient treatment. Specifying a certain
service area and defining the type of intended support might increase the
effectiveness of the appropriation.
FISCAL IMPLICATIONS
The appropriation of
$40.0 contained in this bill is a recurring expense to the general fund. Any
unexpended or unencumbered balance remaining at the end of FY 04 shall revert
to the general fund.
The
funding provided is not specifically targeted and is too limited to have a
significant statewide impact.
ADMINISTRATIVE IMPLICATIONS
Staff
time for contract and program management would be required but could be
absorbed within current day-to-day operations.
RELATIONSHIP
Relates to:
·
SB387 Northern NM Alcohol and Substance Abuse, makes an
appropriation for substance abuse treatment in Northern New Mexico.
TECHNICAL ISSUES
It
is not clear what is meant by long-term outpatient alcohol and substance
abuse treatment. There are a number of
components that can be part of an outpatient alcohol and/or substance abuse
treatment program, e.g., intensive outpatient treatment, individual therapy,
group therapy and family therapy. An individual’s treatment plan may indicate
all of these treatment components are necessary or may indicate one or two of
these components are necessary.
Clarifying the definition of long-term treatment would allow the bill to
target the $40,000 appropriation to specific services and/or populations.
OTHER SUBSTANTIVE ISSUES
Drug and alcohol abuse have been among the most
acute and chronic health problems confronting the State of New Mexico. The DOH
Office of Epidemiology has published statistics that identify New Mexico as
leading the nation in per capita illicit drug overdose deaths. Illicit drug overdose mortality rates in Rio
Arriba County from 1979 to 1997 rose from under 5 per 100,000 persons to 30 per
100,000 persons. In that period the rate of death nationally remained under 5
per 100,000 persons.
Alcohol is a serious factor in the majority of
trauma cases. Over a two-year period, over 50% of all trauma
patients over the age of 16 at New Mexico’s Level I Trauma Center (UNM) tested
positive for blood alcohol. Alcohol was
involved in 44% of all vehicle crashes, 75% of all pedestrian injuries, 76% of
all assaults/domestic violence, 66% of all penetrating injuries, 50% of all
traumatic brain injuries and 35% of all falls.
Alcohol also contributes to many chronic diseases
and premature disability and death.
With
the enormous problems and drug/alcohol in New Mexico, the amount of money being
requested seems too limited to have a significant statewide impact. However if the funds were more specifically
targeted, any number of programs could be expanded or enhanced to better serve
identified populations
HPC reports:
·
“Chronic
Liver Disease and Cirrhosis” is the 7th leading cause of death in
NM, with a crude death rate of 19.1, compared to 9.5 nationally (NM Selected
Health Statistics Annual Report for 2000).
·
The
estimated cost to the State for alcohol-related illnesses and accidents is $70
million, of which about $23.5 million is for uninsured alcohol-related trauma
and illness.
·
In
2001, 3.1% of hospital discharges were related to alcohol/drug abuse treatment
for ages 19-64. Certain groups of New
Mexicans have greater alcohol and substance abuse issues, however: in 2000, alcohol dependence syndrome was the
third most common reason for hospitalization among men, ages 19-44, and drug
dependence was the eighth most common reason.
(Annual Report of 2000 HIDD, HPC)
·
There are 186 outpatient services providers in
New Mexico, though not all provide substance abuse services. Access and availability of inpatient
treatment services in rural areas may be limited, and in some cases may not
available locally.
·
According
to the Department of Health’s Behavioral Health Needs & Gaps in New Mexico:
·
14,660
youths ages 12-17 and 82,235 adults are dependent on alcohol or drugs in NM
(estimates), or 6.5% -- compared to 4.8% nationally.
·
3,047
inmates in NM jails or prisons are estimated to have substance abuse disorders.
·
“For
every dollar spent on alcohol and other drug treatment, $7.14 is saved by reductions
in other social, governmental and economic costs.”
HB
767 could be amended to include a more explicit definition of long-term
outpatient alcohol and substance abuse treatment; a more specific region; a
clearer definition about what type of support; and a more appropriate budget to
match the scope of work intended by this bill.
POSSIBLE QUESTIONS
Could
the appropriation go towards training to increase the ability of practitioners
to assess, identify, and recommend treatment for individuals with Co-occurring
Disorders?
BD/sb