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

SPONSOR Rodriguez

ORIGINAL DATE

LAST UPDATED

01/30/08

HB

SHORT TITLE Clubhouse-Model Program for Mentally Ill

SB 388

ANALYST Weber

APPROPRIATION (dollars in thousands)

Appropriation

Recurring

or Non-Rec

Fund

Affected

FY08

FY09

$250.0

Recurring

General Fund

(Parenthesis ( ) Indicate Expenditure Decreases)

SOURCES OF INFORMATION

LFC Files

Responses Received From

Human Services Department (HSD)

Health Policy Commission

SUMMARY

Synopsis of Bill

Senate Bill 388 appropriates $250 thousand from the general fund to The Human Services

Department to support a day program for persons with severe mental illness using the clubhouse

model to facilitate recovery through socialization and life skills training; vocational rehabilitation

and employment services; educational and housing services; and reintegration into the greater

community.

FISCAL IMPLICATIONS

The appropriation of $250 thousand contained in this bill is a recurring expense to the general

fund. Any unexpended or unencumbered balance remaining at the end of FY09 shall revert to

the general fund.

HSD reports that any behavioral health services provided to Medicaid-eligible individuals would

be eligible for federal match if the following criteria are met:

•

The service must be a benefit under the NM Medicaid State Plan.

•

The provider must be credentialed as a Medicaid provider for that service as part of the

Senate Bill 388 – Page

2

ValueOptions New Mexico provider network; and

•

The provider is providing services in accordance with his or her licensure.

SIGNIFICANT ISSUES

HSD provides the following background information.

The clubhouse model of psychosocial rehabilitation (PSR) is nationally acknowledged as

promoting recovery and resiliency. According to the International Center for Clubhouse

Development website, “ Through participation in a Clubhouse, people are given the opportunities

to rejoin the worlds of friendships, family, important work, employment, education, and to

access the services and supports they may individually need."

As of January 2008, in New Mexico stand-alone programs of this type serving Medicaid-eligible

individuals may bill Medicaid for group-based services, such as life skills training. One-on-one

services that were once a part of PSR will now be provided as a part of comprehensive

community support services.

There is not yet a clubhouse-model program in New Mexico outside of a developing program in

Santa Fe.

The Health Policy Commission contributes additional information.

The bill will provide a “clubhouse" facility where persons with serious mental illness can go for

societal, occupational, and interpersonal needs and to form linkages with sources of care

elsewhere to meet the person’s medical and psychiatric needs. This model will assist the

increasing number of serious mental illness patients make a transition back into society.

The basic premise of the model is that when necessary and cost-effective supports are provided

to persons with severe mental illness, the cost of their medical and psychiatric care decreases and

their quality of life increases. This model could reduce some of the overburdened medical

facilities in New Mexico.

The cost of mental health is expensive and sometimes prohibited. The reliance on public

assistance could place a financial drain on the state of New Mexico. However, most states allow

Medicaid reimbursement for clubhouse services or include clubhouse services as part of a

capitated Medicaid plan.

OTHER SUBSTANTIVE ISSUES

Beginning in FY08 there is a recurring appropriation to the Behavioral Health Services Division

of $30 thousand from the general fund for this purpose.

MW/mt