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F I S C A L I M P A C T R E P O R T
SPONSOR Papen
DATE TYPED 2/8/05
HB
SHORT TITLE Dona Ana Behavioral Health Services
SB 453
ANALYST Hanika-Ortiz
APPROPRIATION
Appropriation Contained Estimated Additional Impact Recurring
or Non-Rec
Fund
Affected
FY05
FY06
FY05
FY06
$2,000.0
Recurring
GF
Duplicates HB 522
Relates to HB 296
SOURCES OF INFORMATION
LFC Files
Responses Received From
Health Policy Commission (HPC)
Department of Health (DOH)
Human Services Department (HSD)
FOR THE LEGISLATIVE HEALTH AND HUMAN SERVICES COMITTEE
SUMMARY
Synopsis of Bill
Senate Bill 453 appropriates $2 million from the general fund to the DOH in FY06 for behav-
ioral health services for persons with serious mental illness in Dona Ana County and southern
New Mexico.
The plan developed by the local behavioral health collaborative (LBHC) and approved by the
interagency behavioral health purchasing collaborative (IBHPC) leverages resources, provides
mobile crisis services, and provides assertive community treatment (ACT) and residential treat-
ment services.
pg_0002
Senate Bill 453 -- Page 2
Significant Issues
DOH reports SB 453 provides for a specialized continuum of intensive services to a high-risk
group of persons with serious and persistent mental illness. ACT is for a relatively small group
of people diagnosed with severe and persistent mental illness who have not responded well to
more traditional services, who experience the greatest impairment in functioning, who have the
most severe difficulties with basic, everyday activities such as keeping themselves safe, caring
for their basic physical needs, or maintaining safe and adequate housing. Extensive histories of
hospitalization, unemployment, substance abuse, homelessness, and involvement in the criminal
justice system are common. Programs that adhere more closely to the ACT model are more ef-
fective in reducing hospital use and associated costs. Like ACT, mobile crisis services require a
freestanding team that has a singular mission.
PERFORMANCE IMPLICATIONS
SB 453 relates to the DOH Strategic Plan in Program Area 5 to increase access and choice for
behavioral health services.
FISCAL IMPLICATIONS
The appropriation of $2 million contained in this bill is a recurring expense to the general fund.
Any unexpended or unencumbered balance remaining at the end of FY06 shall revert to the gen-
eral fund.
The appropriation requested was not part of the agencies budget request reviewed by the LFC in
2004. Any LFC appropriation recommendation is balanced between revenues and expenditures
and any increase in recurring funding must be offset by reductions in other areas. The Legislature
must consider all priorities and funding requirements to find revenue to support this legislation.
The DOH reports when teams adhere closely to the ACT program model, costs are offset by re-
duced hospitalization costs, estimated at $9,000 to $12,000 per year per person. The Lewin
Group has developed a program to help mental health systems project the cost of ACT. ACT is a
reimbursed expense under Medicaid.
HSD is currently developing an ACT program with the City of Albuquerque.
ADMINISTRATIVE IMPLICATIONS
SB 453 requires the LBHC and the IBHPC approve the planning and implementation process.
CONFLICT, DUPLICATION, COMPANIONSHIP, RELATIONSHIP
Duplicates HB 522, Dona Ana Behavioral Health Services.
Relates to HB 296, Dona Ana Short-Term Psychiatric Program, allocating $2 million to the DOH
for different services for the mentally ill in Dona Ana County, which are an assessment and
treatment program, and a crisis residential program.
pg_0003
Senate Bill 453 -- Page 3
TECHNICAL ISSUES
None indicated.
OTHER SUBSTANTIVE ISSUES
The HPC reports on New Mexico Mental Health Statistics:
•
The discharge rate per 100,000 population for Mental Disorders was 3.6 for New Mexico
and 7.7 for the US.
•
For the 18 and under age group for both males and females of 2001, Affective Psychoses
ranked 2
nd
as the leading cause of hospitalization.
•
For the 19-44 age group for males of 2001, Affective Psychoses ranked 1
st
as the leading
cause of hospitalization and 5
th
for females.
•
For the 45-64 age group for females of 2001, Affective Psychoses ranked 1
st
as the lead-
ing cause of hospitalization and 6
th
for males.
Department of Health:
•
Over 500,000 individuals in New Mexico have substance abuse/dependence or mental
disorders.
•
It is estimated that in New Mexico, 19,025 youth and 131,112 adults (including 3,047 in-
dividuals in the state’s jails and prisons) have substance use disorders.
•
Approximately 25-35 percent of those New Mexicans with substance use and/or mental
health disorders will need services from the publicly funded system of care.
•
368,721 individuals in New Mexico have some kind of mental disorder. 70,766 of these
individuals have serious mental illness.
•
Depression affects about 6 million elderly, and only 10% receive treatment.
Health Professional Shortages and Access to Care:
•
New Mexico is experiencing a shortage of a wide range of health professionals to staff
health care and mental health facilities resulting in long waiting lists or delays for con-
sumers.
•
Compounding the health professional shortage is the high number of uninsured New
Mexicans, who must often wait to receive medical and mental health services from agen-
cies that serve the uninsured and underinsured.
o
21.3% of New Mexicans are uninsured
o
Research has shown 1 out of 5 Americans has a mental disability, which may in-
clude people with substance abuse illness. Many private health insurance plans
provide less coverage for mental health problems than for medical health prob-
lems or no coverage at all, forcing consumers to pay out of pocket expenses.
Dona Ana County Facts:
•
Dona Ana County is the state’s second most populated county with a 2003 population es-
timate of 182,165.
•
20% of the county’s families are below poverty.
•
27.9% of the population are Medicaid enrolled; 12.2% are Medicare.
pg_0004
Senate Bill 453 -- Page 4
•
The rate of hospitalizations for persons diagnosed with a mental disease or disorder in
Dona Ana County was 7.3 in 2001 compared to the New Mexico rate of 5.2 (per 1,000).
•
Average hospital days spent by Dona Ana County residents for mental disease treatment
ranked 5
th
highest in the state and 13
th
highest for treatment of drug and alcohol depend-
ency.
ALTERNATIVES
None identified.
WHAT WILL BE THE CONSEQUENCES OF NOT ENACTING THIS BILL.
Dona Ana county and southern New Mexico citizens may be underserved in the area of mental
health services.
AHO/njw