Two years after blowing New Mexico’s community behavioral health system to smithereens and bringing in companies from Arizona to replace it, spending $27 million in the process, the topic of behavioral health drew nary a mention from our Governor in her State of the State speech.
Nor did any of the press releases that accompanied her proposed budget for next year mention the topic. It is not the subject of any legislative proposals sent down from the Fourth Floor. She has no position on Albuquerque and Bernalillo County’s efforts to address the needs of the mentally ill and addicted populations, which include requests for additional taxes here and for increased State appropriations for services.
No, it seems that behavioral health, the gaps in our addiction, alcoholism and mental health services; the mounting demand for court-related services; the glaring holes which shred the system; the financial distress of many of the service provider agencies, which have survived and the growing call for prevention and diversion, which are largely non-existent currently—all of that has just not risen to the level of concern sufficient to draw Governor Martinez’ attention.
Instead, she has chosen to focus on other worries more critical to her: drivers licenses for the undocumented; photo identification requirements for voters and resisting all efforts at replacing faltering oil and gas tax revenues with any new revenue sources. She is Spartan in her fiscal stance, preferring austerity to seeking any way to finance the services we don’t now have, no matter how bad the need.
If her administration had not taken such a reckless role in creating our current behavioral health mess, this lack of attention to fixing it might be excused. But oh how this state could use that wasted $27 million now! And oh how this state needs a chief executive who might be willing to spend time realistically facing this need instead of occupying herself with yet more of the reading sessions with school kids that have become clichés.
There are three things the Governor needs to do in the next few months that would signal she is prepared to work at salvaging our behavioral health system. These suggestions aren’t photo ops. Rather, they require real attention, real work and real follow-through on her part. But if she’s serious about running this state, she must tackle them or risk total irrelevance.
First, there is a true emergency occurring regarding payments to the local providers who do the actual work with clients for Medicaid. One year into the new Centennial managed care system, it appears that the $590 million dollars for behavioral health that are given to the four HMO’s that run it, are mostly sitting in those companies’ bank accounts. They certainly aren’t getting out to where services are needed.
The result is that some are closing their doors. Others are laying off staff. All are wasting inordinate amounts of time arguing with the HMO’s about the accuracy of billings or the need for services. An involved chief executive would bring the HMO‘s in and read them the riot act. Their failings are making her look bad…worse, they are ripping off the people of New Mexico who are paying for services, not endless red tape.
Second, the Governor needs to get on board with the legislative initiative to expand behavioral services through non-Medicaid sources. A package of six funding bills was cobbled-together before the session, a plan for increasing our capacity to provide services statewide that phases-in over five years. The administration is silent on this plan so far. If she doesn’t like it, she needs to come up with her own; but she should take a stand. We don’t need a leader who hides her head in the sand in the face of this crisis.
Finally, the Governor supports longer sentences for people convicted of crimes. But time in prison becomes wasted time or time spent only on honing criminal skills if our Corrections Program doesn’t offer effective mental health and addiction treatment. It is even better (because it is less expensive and less damaging to future lives) to divert drug and alcohol-dependent offenders away from prison and into community treatment.
We don’t have a lot of new money for new programs this year. But shifting money from prisons to treatment doesn’t take new money…and it works a lot better.