Report Type: Plan Recommendations
Behavioral Health Needs & Gaps NM (Recommendations)
YEAR
2002
AUTHOR / ORGANIZATION
Technical Assistance Collaborative, Inc. & Human Services Research Institute
GEOGRAPHIC SCOPE
Behavioral Health Region, Bernalillo County, Statewide (New Mexico)
What is this?
This is a chapter from a comprehensive statewide behavioral health assessment and planning document for New Mexico, presenting formal recommendations for system transformation. The document appears to be part of a larger study ("this report" references earlier chapters on prevalence, services, regions, and finances). The methodology underlying these recommendations includes needs assessments, gap analyses, service taxonomy development, financial analysis, and comparison with evidence-based practices from other states. The recommendations are designed to be implemented through a combination of executive action, legislative changes, regulatory reforms, and regional planning processes.
Summary
This comprehensive set of recommendations addresses fundamental barriers in New Mexico’s behavioral health system: multiple disconnected systems, inconsistent data, service inadequacies, workforce shortages, and inadequate funding. The centerpiece is creating a Behavioral Health Cabinet Cluster to provide unified leadership across all state agencies with behavioral health responsibilities, including DOH, CYFD, HSD, and others. For services, the report recommends developing core services in every region including crisis response, intensive community-based services, case management, supportive housing, and rehabilitative/recovery services—with crisis services specifically designed to divert from jails and hospitals. School-based mental health services should have statewide standards addressing clinical competencies and minimum service capacity at every grade level. The workforce recommendations call for establishing a New Mexico Behavioral Health Institute to lead human resource development planning, training, and evidence-based practice implementation. Critically, the recommendations emphasize maximizing Medicaid resources by moving optional behavioral health services to mandated status, redesigning benefits to support evidence-based practices, and using state dollars currently funding non-Medicaid services as federal match. For Bernalillo County, these recommendations provide a template for advocating for regional planning authority, standardized crisis services, and workforce investments.
BH Systems Change Recommendations
1. Create a Behavioral Health Cabinet Cluster at the state level to provide unified leadership, direction, and planning for all behavioral healthcare systems 2. Develop and utilize common service system goals and expectations across all departments 3. Develop and utilize common service definitions using an agreed-upon taxonomy 4. Select or develop common assessment and utilization management tools and protocols 5. Require regional planning using common boundaries that encompasses all players and services 6. Clarify administrative responsibility for persons with MRDD and mental illness/substance abuse, and for adolescents with substance abuse needs 7. Increase support for consumer and family services and advocacy efforts at state and regional levels 8. Develop and utilize common reporting system requirements including common data elements and unique client identifiers 9. Create a single behavioral health provider agency and practitioner registry 10. Develop a common set of core services across all systems for each region (crisis services, intensive community-based services, case management, supportive housing, rehabilitative services, client/family support) 11. Develop standards for school-based mental health services and DWI programs 12. Require and/or provide incentives for adherence to evidence-based practices 13. Redesign Medicaid benefits to maximize attention to evidence-based practices, including mandating optional behavioral healthcare benefits 14. Maximize housing, vocational rehabilitation, and educational resources for persons with behavioral health needs 15. Create a statewide behavioral health research and development capacity 16. Create a New Mexico Behavioral Health Institute for workforce development and research 17. Develop comprehensive statewide and regional human resource development plans 18. Change licensure rules that create barriers to reciprocity 19. Require annual data collection from licensed professionals and provider agencies 20. Implement incentives for recruiting and retaining practitioners in rural and underserved areas 21. Redesign credentialing processes for a single process across all systems 22. Develop and implement a plan to maximize Medicaid resources 23. Set a common rate schedule for commonly defined services across all systems 24. Provide start-up funding for services and infrastructure priorities 25. Fund single regions to pilot comprehensive services before statewide expansion
How to Use for Systems Planning
What this report IS useful for in systems planning: - Provides a comprehensive framework for unifying fragmented behavioral health governance structures - Offers specific service priorities and core service definitions for regional planning - Identifies evidence-based practices that should guide benefit design and service standards - Outlines workforce development infrastructure needs including the Behavioral Health Institute model - Presents a phased implementation approach with prioritized funding categories - Describes strategies for maximizing Medicaid federal match through benefit redesign What this report DOES NOT provide: - Specific cost estimates for implementing individual recommendations - Detailed operational guidance for implementing service models - Current data on system status (report appears to be from early 2000s based on references) - Metrics or outcome measures for evaluating implementation success - Templates for regional plans or Cabinet Cluster governance structures - Analysis of political feasibility or stakeholder engagement strategies
Key Facts & Data Points
- Medicaid services in New Mexico are funded approximately 75% by federal dollars - The report identifies 25 specific recommendations organized across system, service, human resource, and financial categories - Multiple state agencies have behavioral health responsibilities: MAD, CYFD, BHSD, DFA/DWI, DOC, OSH, DHI, DDPC, and others - New Mexico uses three statewide managed care organizations for Medicaid - Current Medicaid mandates only inpatient, outpatient, psychosocial rehabilitation, and targeted case management for adults with mental illness - All other adult services are optional or "enhanced" including crisis services, substance abuse treatment, and consumer/family education - The report proposes five regional planning areas for behavioral health - School-based services, DWI programs, and credentialing processes all require standardization across the state
Priority Services & Findings
**SUD Organizations**: Recommends standardized DWI program services across all counties with uniform services, engagement length, and expected outcomes; calls for intensive outpatient services for substance abusing adults and ambulatory detoxification alternatives; identifies adolescent substance abuse services as a priority needing clear agency responsibility between CYFD and BHSD **Mental Health / Crisis Care**: Emphasizes comprehensive, integrated crisis response services available regardless of funding source including 24/7 telephone triage, mobile response, walk-in services, non-medical detoxification, short-term crisis residential, and transportation; crisis services should be designed to divert from jails and hospitals; recommends assertive community treatment and intensive case management for adults with serious mental illness **Integrated Primary Care**: Recommends maximizing use of rural health clinics and primary care physicians/nurse practitioners especially in rural areas; calls for integrated treatment for persons with co-occurring mental illness and substance abuse disorders; emphasizes coordination between behavioral health and housing, vocational rehabilitation, and educational resources **School-Based / Youth Services**: Calls for statewide standards for school-based mental health services developed by OSH, BHSD, DHI, and SDE; standards should address clinical competencies, settings, and minimum service capacity requirements for every school at each grade level; recommends in-home and wrap-around services for children and families including therapeutic foster care
Immediate Actions for Systems Planners
-Assess current alignment of Bernalillo County behavioral health governance with the Cabinet Cluster model and identify opportunities to advocate for unified regional planning authority -Map existing crisis services against the recommended core crisis service components (24/7 triage, mobile response, walk-in, detoxification, crisis residential, transportation) to identify gaps -Review current Medicaid managed care contracts to identify which recommended "enhanced" services could be moved to mandated status -Inventory school-based behavioral health services across Bernalillo County school districts against the recommended minimum capacity standards -Evaluate workforce data collection mechanisms against recommendations for practitioner registry and common data elements -Identify pilot opportunities to develop comprehensive services for a specific population or service type as recommended for regional demonstrations -Assess current credentialing processes across RCCs, MCOs, and other payers to identify consolidation opportunities
Key Contacts
**/ - Bazelon Center for Mental Health Law = - Behavioral Health Services Division (BHSD) = - Children, Youth & Families Dept (CYFD) = - Dept of Health (DOH) = - Developmental Disabilities Planning Council (DDPC) **/ - Dept of Finance & Administration/DWI (DFA/DWI) = - Dept of Corrections (DOC) = - Division of Health Improvement (DHI) = - Governor's Mental Health Planning Council = - Indian Health Service (IHS) **/ - Long Term Services Division (LTSD) = - NASMHPD Research Institute = - National Alliance for the Mentally Ill = - NM Health Policy Commission = - Medical Assistance Division (MAD) = - Office of Substance Abuse (OSH) = - Parents for Behaviorally Different Children = - State Dept of Education (SDE)