Fiscal impact reports (FIRs) are prepared by the Legislative Finance Committee (LFC) for standing finance committees of the NM Legislature. The LFC does not assume responsibility for the accuracy of these reports if they are used for other purposes.

Current FIRs (in HTML & Adobe PDF formats) are available on the NM Legislative Website (legis.state.nm.us). Adobe PDF versions include all attachments, whereas HTML versions may not. Previously issued FIRs and attachments may also be obtained from the LFC in Suite 101 of the State Capitol Building North.

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

SPONSOR	Taylor, TC		DATE TYPED	2/5/04		HB	384
SHORT TITLE		Totah Behavioral Health Authority Services				SB
					ANALYST		Dunbar

APPROPRIATION

Appropriation Contained		Estimated Additional Impact		Recurring or Non-Rec	Fund Affected
FY04	FY05	FY04	FY05
	$100.0			Recurring	General Fund

(Parenthesis ( ) Indicate Expenditure Decreases)

Relates to Appropriation in the General Appropriation Act which contains an appropriation for $75.0 for the Totah Authority.

SOURCES OF INFORMATION

LFC Files

Responses Received From

SUMMARY

Synopsis of Bill

House Bill 384 appropriates $100,000 from the General Fund to the Department of Health to contract for behavioral health services for the Totah Behavioral Health Authority in Farmington.

Significant Issues

According to DOH, the Totah Behavioral Health Authority, that began 2 years ago, has brought an innovative, fresh approach to behavioral health service issues in the Farmington area. The Authority consists of the relevant stakeholders, including the Navajo Nation, working together collaboratively for the first time. This effort is showing positive results but continued support is needed. The Totah is currently in its final year of federal U.S. Health Resources and Services Administration/Healthy Communities Access Program (HRSA/HCAP) funding.

FISCAL IMPLICATIONS

The appropriation of $100.0 contained in this bill is a recurring expense to the General Fund. Any unexpended or unencumbered balance remaining at the end of FY 05 shall revert to the General Fund.

The General Appropriation Act as passed by the NM House contains $75.0 for the Totah Authority.

An annual budget of approximately $714,000 allows the Totah BHA to retain a staff of twelve including a traditional Navajo counselor, a substance abuse counselor, 5 case managers, a clinical supervisor, one and a half administrative assistants, and an executive director.

ADMINISTRATIVE IMPLICATIONS

The additional funding can be administered through the Department of Health/Behavioral Health Services Division’s (BHSD) existing Regional Care Coordination (RCC) management process.

OTHER SUBSTANTIVE ISSUES

The Totah BHA is a collaborative effort between the Navajo Nation, San Juan County, the City of Farmington, and other key local community agencies. These include Presbyterian Medical Services, which is the BHSD’s Regional Care Coordinator (RCC) for this region; Four Winds Recovery Center, Farmington Intertribal Indian Center, and DOH Public Health District 1.

Totah’s Mission is to provide access to culturally appropriate and clinically proficient behavioral health care and related services. Its intention is to promote the health and well-being of the uninsured, indigent Native American population in the area and to intervene in the progression of alcoholism, drug addiction and co-occurring disorders, assist in appropriate treatment referrals and support healthy, productive reintegration into family and community life.

Totah has been successful in two ways: (1) Bringing its diverse members into a single planning body to make collaborative, consensus-based decisions, creating a powerful change in the planning and delivery of services, and (2) Changing from the previous “protective custody and release” approach to one in which the Native American stakeholders are an integral, decision-making component of the program design and implementation.

Since the inauguration of services, Totah has contacted over 500 individuals who fit the criteria. Based in harm reduction theory and employing outreach and facilitated case management models, Totah serves an average active case load of 115 clients and has successfully referred 67 clients to inpatient treatment for alcoholism. Approximately 90% of its clients are Native American; of that number almost 95% are Diné (Navajo).

BD/njw