Report Type: Data Profile Funding Medicaid Recommendations
Behavioral Health & Substance Use Treatment Gap Analysis
YEAR
2024
AUTHOR / ORGANIZATION
NM Legislative Finance Committee
GEOGRAPHIC SCOPE
Behavioral Health Region, Bernalillo County, Statewide (New Mexico)
What is this?
This is a gap analysis presentation prepared by the Legislative Finance Committee (LFC) for the New Mexico Legislature, presented on November 18, 2024. The report examines behavioral health and substance use treatment funding, workforce trends, and service availability across New Mexico. The methodology includes analysis of Medicaid expenditure projections, National Provider Identifier (NPI) files for workforce counts, federal grant data from SAMHSA, HRSA, HUD, and Office of Justice, and state budget appropriations. Data is organized by Local Collaborative regions to identify geographic variations in workforce and funding.
Summary
This gap analysis identifies critical systemic challenges in New Mexico’s behavioral health delivery system that directly inform Bernalillo County planning efforts. The state’s behavioral health spending exceeds $1.1 billion annually across collaborative agencies, with $900 million flowing through Medicaid, yet coordination gaps persist. Local Collaborative Area 2 (Bernalillo County) received significant federal grant investment including $72.2 million for UNM, $42 million for First Choice Community Healthcare, and $54.7 million in HUD housing grants. Provider workforce in Bernalillo County shows growth in most categories, with behavior technicians increasing 82% and nurse practitioners 54% between 2020-2024. The report recommends implementing Certified Community Behavioral Health Clinics in high-need communities (with $15 million in GRO funding already appropriated), requiring Medicaid single credentialing to reduce administrative burden, and expanding medication-assisted treatment availability in pharmacies and primary care settings. Seven CCBHCs are expected operational by January 2025. For Bernalillo County systems planners, the analysis highlights the need for integrated service delivery, improved data systems, and coordination with state-level planning to address the disconnect between high investment and poor outcomes.
BH Systems Change Recommendations
Explicit recommendations from the report: 1. Require Medicaid-funded Certified Community Behavioral Health Clinics in high-need communities to ensure access to the full array of services 2. Authorize the pharmacy board and Department of Health to require pharmacies in high-need locations to make available medication-assisted treatment (MAT) 3. Work to get more MAT adopted and prescribed in primary care settings 4. Require Medicaid to implement single credentialing to reduce the need to work with multiple MCOs to become reimbursable within their networks 5. Expand availability of services including Intensive Out-Patient Services, Functional Family Therapy, and Transitional Housing 6. Develop an "all-of-government" behavioral health plan similar to other states and many NM communities 7. Integrate local behavioral health needs assessments and planning in state planning and priority setting 8. Expand programs such as non-emergent transportation, telehealth, "Treat First," and integrated care to make existing capacity more accessible 9. Streamline and rationalize oversight and administration of behavioral health programs
How to Use for Systems Planning
What this report IS useful for: - Understanding the fragmented landscape of behavioral health funding across 17 state agencies - Identifying workforce trends by provider type and Local Collaborative area (Bernalillo County data on pages 23) - Tracking federal grant funding flows to local communities and provider organizations - Benchmarking New Mexico's behavioral health outcomes against national rankings - Understanding the CCBHC model and expected expansion timeline - Identifying Medicaid spending trends and managed care organization network changes What this report DOES NOT provide: - Client-level utilization data or service access metrics - Wait time or capacity analysis for specific services - Quality outcomes or evidence-based practice penetration rates - Detailed analysis of unmet need by population or geography - Cost-effectiveness analysis of different intervention models - Specific provider network adequacy findings beyond count trends
Key Facts & Data Points
- New Mexico ranks 49th nationally for adult substance use disorder (23% rate) and 51st for youth substance use disorder (16% rate) - 17 state agencies and local communities have behavioral health responsibilities - Total collaborative agency spending budgeted at $1.1 billion in FY25, a 25% increase since FY22 - Medicaid behavioral health spending: $900 million, projected 25% growth from FY22-FY25 - Interagency Behavioral Health Purchasing Collaborative contracts $206 million in FY25 - $424 million in nonrecurring behavioral health appropriations from FY20-FY25, with 73% unspent - 42% of New Mexico population covered by Medicaid - Statewide counselors increased 17%, social workers 32%, and behavior technicians 212% from 2020-2024 - Bernalillo County (LC2) population: 671,586 - Seven Certified Community Behavioral Health Clinics expected operational January 2025 - $15 million in GRO funding appropriated for CCBHC startup - More than half of federal grant dollars over 10 years went directly to provider entities ($1.65 billion)
Priority Services & Findings
**SUD Organizations** - Medication-Assisted Treatment (MAT) access limited in high-need areas due to pharmacy restrictions - Substance abuse rehabilitation facilities increased 47% statewide from 2020-2024 - Intensive Out-Patient Services identified as needing expansion - SBIRT (Screening Brief Intervention and Referral to Treatment) funded through GRO appropriations - Transitional housing identified as service gap - MAT in carceral settings 90 days prior to release recommended **Mental Health / Crisis Care** - Seven CCBHCs launching January 2025 with $15 million startup funding - CCBHCs provide 24/7 crisis services and integrated mental health, substance use, and physical health services - Psychiatric Residential Treatment Facilities declined 25% statewide - Community Based Residential Treatment Facilities for mental illness declined 14% - Crisis intervention and crisis teams identified as key services **Integrated Primary Care** - CCBHCs emphasize care coordination across providers for holistic treatment - Recommendation to expand MAT in primary care settings - Medicaid single credentialing recommended to reduce provider administrative burden across MCOs - Turquoise Care adding evidence-based behavioral health treatment modalities **School-Based / Youth Services** - New Mexico ranks 46th for youth with major depressive episode (23%) - 51st for youth substance use disorder (16%) - Residential Treatment Facilities for Emotionally Disturbed Children declined 6% - Multisystemic Therapy, Functional Family Therapy, and Wraparound Services listed as key children's behavioral health services - Continuous eligibility for children under six added through Turquoise Care
Immediate Actions for Systems Planners
-Coordinate with state agencies on CCBHC implementation planning as seven clinics launch in January 2025, identifying which will serve Bernalillo County and how to integrate with existing crisis and treatment services -Analyze the $54.7 million in HUD housing grants flowing to Albuquerque and coordinate supportive housing behavioral health services with housing placement -Review Medicaid single credentialing implementation timeline to prepare providers for streamlined enrollment across MCOs -Engage with Turquoise Care MCO transition (effective July 2025) to ensure behavioral health network adequacy with new supportive housing benefits and evidence-based treatment modalities -Map current MAT availability at pharmacies in high-need Bernalillo County areas to support potential pharmacy board requirements -Inventory nonrecurring appropriation funding ($424 million statewide, 73% unspent) and track local allocation status through state share systems -Utilize the federal grant data to identify potential new funding sources from SAMHSA, HRSA, HUD, and Office of Justice for local initiatives
Key Contacts
**/ - Eric Chenier, Principal Analyst, Legislative Finance Committee **/ - Behavioral Health Planning Council = - Dept of Health - Division of Health Improvement = - City of Albuquerque = - Children, Youth & Families Dept - CYFD Behavioral Health Services **/ - First Choice Community Healthcare, Inc. = - Healthcare Authority - Behavioral Health Services * Medical Assistance Divisions = - Interagency Behavioral Health Purchasing Collaborative = - Substance Abuse Prevention Council = - UNM