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

SPONSOR	Gonzales		DATE TYPED	2/2/04		HB	227
SHORT TITLE		Taos County Substance Abuse Services				SB
					ANALYST		Johnson

APPROPRIATION

Appropriation Contained		Estimated Additional Impact		Recurring or Non-Rec	Fund Affected
FY04	FY05	FY04	FY05	Recurring or Non-Rec	Fund Affected
	$54.0			Recurring	GF

(Parenthesis ( ) Indicate Expenditure Decreases)

Duplicates to SB376

SOURCES OF INFORMATION

LFC Files

Responses Received From

Department of Health (DOH)

Office of District Attorneys

SUMMARY

Synopsis of Bill

House Bill 227 appropriates $54,000 from the general fund to the local government division of the department of finance and administration for expenditure in FY2005 to contract for provision of substance abuse services in the community of Talpa in Taos County.

Significant Issues

The department of health provided the following information:

Substance abuse is a serious problem in New Mexico, and in particular, in Taos County. According to the 2002 Taos County Youth Risk and Resiliency Survey, 30% of students reported their first drink of alcohol at age 11 or younger and 56% of these students said it would be “very easy” to get beer, wine and hard liquor if they wanted it. Taos’ rate of past year alcohol use (grades 9-12),1997, equaled the New Mexico rate at approximately 70%. Taos rates of reported drinking and driving (grades 9-12), 1997, showed over 20%, a rate similar to the New Mexico rate. (Source: 1997 New Mexico Social Indicator Project Report 1995-1997, October 1999). The DOH Taos County 2002 County Health Profile lists Taos County alcohol related deaths at 15.3 per 100,000 (the state rate is 17.5).

Along with the high rate of alcohol abuse in Taos County, a significant factor is that Talpa, a rural community, has few resources for prevention, peer support or treatment of substance abuse. However, an organization entitled “In God We Trust” (IGWT), housed in the Talpa Community Center, which is the hub of the community, could provide a 12-step self-help program for substance abusers. Because the agency, which will ultimately receive these funds, is outside the DOH system, there are no performance indicators or measures to gauge the effectiveness of the funding. There are no standards that this program would have to adhere to.

The appropriation contained in the bill would need to be integrated into regional and DOH behavioral health planning efforts to assure tracking of performance outcomes and deliverables.

FISCAL IMPLICATIONS

The appropriation of $54.0 contained in this bill is a recurring expense to the general fund. Any unexpended or unencumbered balance remaining at the end of fiscal year 2005 shall revert to the general fund.

ADMINISTRATIVE IMPLICATIONS

The department of health provided the following:

Substance abuse prevention is a priority of the New Mexico Department of Health (DOH). HB 227 supports the DOH Strategic Plan, Program Area 5 Behavioral Health Services, Goal B: Assure access to an effective, consumer-driven, integrated continuum of safety net services for adults with behavioral health needs in order to stabilize and improve their functioning levels; Objective 2: Stabilize and improve the functioning and quality of life of persons receiving community-based and facility-based behavioral health services. Performance measure 5.B. 2.1: Percent of adults receiving community-based substance abuse services who experience diminishing severity of problems after treatment.

TECHNICAL ISSUES

The department of health provided the following:

DOH suggests providing additional funding support to Taos County through the Regional Care Coordination system overseen by DOH/BHSD, which could ensure accountability for using evidence-based strategies, inclusion in a continuum of care, and other accepted standards for the provision of substance abuse services. This would also enable an evaluation of efficacy of the program, and tie it to the DOH performance measures.

The term, “substance abuse services” is very vague and needs to be tightened up, with definition and specific goals as to what these services are, e.g., prevention, treatment, peer support, self help, etc.

OTHER SUBSTANTIVE ISSUES

The department of health provided the following:

The appropriation in HB 227 may be targeted for “In God We Trust”, a 501-C3 organization associated with the Talpa Community Center. It is currently operated by volunteers, is not faith-based, and is similar to Alcoholics Anonymous in that it provides peer support and acknowledgement of a “higher power”. It does not employ licensed therapists or theoretical treatment models; rather, it is a grass roots peer advocacy model. The originator of this program, who is in recovery, saw a need for substance abuse services in his small, isolated, rural community of Talpa, and developed the program about a year ago. Taos county judges refer people from the courts to participate in IGWT as part of their sentence. Although several community members have participated in the program, DOH was unable to acquire the actual number of participants.

Twelve-step based programs are an important and beneficial aspect of recovery for many consumers; however, they are not treatment programs. BHSD views 12-step based programs such as this one as an important and beneficial aspect of recovery for many consumers; however it is not a full continuum of care, but rather support for persons addicted to alcohol. Because IGWT is an isolated program not associated with other substance abuse initiatives in Taos County, provisions should be made to ensure that this program is connected to a continuum of care; i.e. to other substance abuse services in Taos County, ranging from prevention to treatment.

An alternative would be to provide additional support through the Regional Care Coordination system overseen by DOH/BHSD, which could ensure accountability for using evidence-based strategies, inclusion in a continuum of care, and other accepted standards for the provision of substance abuse services. This would also enable an evaluation of efficacy of the program, and tie it to the DOH performance measures.

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