Behavioral health package shifts responsibility to the courts
The New Mexico Senate Finance Committee questioned Administrative Office of the Courts Director Karl Reifsteck and Health Care Authority Cabinet Secretary Kari Armijo about their roles in a proposed overhaul of the state's behavioral health system on Feb. 11, 2025. (Photo by Austin Fisher / Source NM)
Ahead of an expected vote on Wednesday, the Senate Finance Committee on Tuesday adjusted the package of legislation meant to rebuild New Mexico's behavioral health system.
Senate Finance Committee analyst Adrian Avila on Tuesday morning summarized changes to Senate Bills 1, 2 and 3, which taken together would shift much of the oversight of the state's behavioral health system to the state court system, but provide key roles for local government and the state's Health Care Authority.
The legislation requires the state Health Care Authority to provide an initial set of proper treatment standards and local gaps in services to the courts, Avila said.
But it makes the Administrative Office of the Courts responsible for making plans for what the specific behavioral health needs are in each region of the state, and for providing case management, Avila said.
He said this part of the bill 'speaks with' the crime package being debated in the House of Representatives by making clear which services are available to someone if they're committed into a locked psychiatric facility.
The committee's substitute for Senate Bill 3 would require the state court system, with HCA's help, to host regional meetings with experts to set priorities in their local areas to determine which services to deploy.
Experts for those 'behavioral health regions' would include public defenders, prosecutors, the Children Youth and Families Department, school districts, police, jails and local behavioral health providers, among others, Avila said.
'When the courts know what services are available, then they have an incentive to ensure those services are functional, because it can prevent people from ever going into the criminal justice system,' Avila said.
AOC Director Karl Reifsteck said his agency will take the Legislature's direction and try to do everything it asks, and it has some momentum from doing this kind of planning work in Santa Fe and Rio Arriba counties with the money lawmakers set aside during the special session in the summer.
'This is a huge expansion of what we do in terms of effort but we'll take it on because this is a big, important project for our state,' he said.
Senate Finance Committee Chair George Muñoz (D-Gallup) said the committee will vote on the bills on Wednesday morning.
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Senate Bill 1 would create a $1 billion Behavioral Health Trust Fund that would pay out 5%, or $50 million, each year, in the form of grants to providers in each region, Avila said.
If a particular organization receives grant money from the regions and doesn't prove it's functioning well, the bill would allow the regions to take the money back and move it into another fund or priority in that local area, Avila said.
The legislation makes the state Health Care Authority responsible for tracking contracts and grants, and ensuring the plans at the local level do not jeopardize the state Medicaid system, Avila said.
The committee's substitute for Senate Bill 2 sets aside money for building out the infrastructure needed to use the state Medicaid program to pay for the behavioral health services to patients, Avila said.
Senate Majority Whip Michael Padilla (D-Albuquerque) and Sen. Jeff Steinborn (D-Las Cruces) repeatedly asked for the legislation to include identifying some kind of project manager to be responsible for the behavioral health system's overall success.
Avila said ideally that responsibility would lie with the Behavioral Health Services Division at HCA. He said the draft legislation would be changed on Tuesday 'with some mechanism' to address the senators' concerns.
HCA Cabinet Secretary Kari Armijo said she isn't opposed to creating some kind of executive office to oversee these local behavioral health regions, and noted that the Behavioral Health Collaborative created by the Legislature more than 20 years ago 'hasn't really worked.'
Avila said the legislation repeals the state law which created the collaborative, because it 'hasn't met for a long time, has been very inefficient, there's very little, if any trust in it functioning.'
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