Behavioral health overhaul picking up steam at Roundhouse

SANTA FE — New Mexico lawmakers’ push to overhaul the state’s mental health and substance abuse treatment system is creating unlikely political bedfellows but still faces a long road to approval.

During a Senate committee hearing this week, the chamber’s Democratic and Republican floor leaders — Peter Wirth of Santa Fe and William Sharer of Farmington — sat together on the dais to present one of the three bills in a behavioral health package.

Several other top Republicans and Democrats are teaming up to carry the other two bills.

“Things are getting worse, not better,” Sharer said during a Tuesday interview. “So this is it.”

He said the seeds for the bipartisan approach were planted during interim committee meetings last summer and were sparked by a shared desire to remodel a fragmented and largely ineffective state behavioral health system.

Behavioral health has emerged as a key issue during this year’s 60-day legislative session as lawmakers look for ways to reduce homelessness, drug use and violent crime.

A recent report by the New Mexico Justice Reinvestment Working Group found that 65% of individuals who enter the state’s criminal justice system have a behavioral health need that they are not receiving treatment for.

In addition, New Mexico has one of the nation’s highest suicide rates, and more than one-third of state residents reported anxiety or a depressive disorder in 2023, according to Kaiser Family Foundation data.

Sharer and other backers say the proposed package would increase accountability by requiring regional plans outlining priorities for providing mental health and substance abuse treatment. A new $1 billion trust fund would provide at least $50 million of annual funding to support the regional plans, which would largely be overseen by the state’s judiciary.

“This is a huge, huge amount of money, but also a huge accountability piece,” Sharer told the Journal.

While the state is projected to spend roughly $1.1 billion on behavioral health programs in the current budget year, the state’s behavioral health collaborative has not met in over one year and does not have an appointed director.

How the bipartisan package came about

Adrian Avila, the chief of staff for the Senate Finance Committee, was tasked with taking the lead on crafting the package after a special session called last summer by Gov. Michelle Lujan Grisham ended with the Democratic-controlled Legislature declining to take up most of the governor’s crime-focused agenda.

Avila described the package that grew out of countless meetings and negotiations as a “bottom-up” approach to tackling mental health and drug abuse issues across the state.

“We’re creating an entire ecosystem here,” he said during a Tuesday meeting of the Senate Finance Committee.

Avila traveled to Miami last year, along with behavioral health advocates, to tour a Miami-Dade County diversion program that has drawn accolades for its success.

He said the “Miami model” would not be totally feasible in New Mexico, however, since the state’s population is not as densely concentrated.

Under the proposed legislation, the new model would put the state judiciary in charge of planning while leaving the state Health Care Authority largely in charge of overseeing funding.

That would be a significant change from the current system, which largely falls under the executive branch’s jurisdiction.

“Right now, we’ve been flying blind,” Avila said.

For his part, Wirth said it’s imperative the courts receive sufficient funding to carry out implementation of the region-based approach.

“They’ve been willing to step up and we have to make darn sure they have the resources to do it,” he said during a committee hearing this week.

Bills could move quickly to governor’s desk

The package of behavioral health bills has already passed its first Senate committee and could hit the chamber floor by as early as next week.

Wirth has expressed optimism the package could reach the governor’s desk by the midpoint of the 60-day session, which is Feb. 20.

But despite the bipartisan support, not all lawmakers are fully on board with the proposed package.

Sen. Larry Scott, a Hobbs Republican, cast the lone “no” vote against the bill in the Senate Health and Public Affairs Committee and said he remains concerned about accountability safeguards.

“I remain skeptical that this approach is going to be successful because I don’t see a single responsible agency,” he said.

In addition, the Governor’s Office is still evaluating the package of bills and has not yet taken a formal position, Lujan Grisham spokesman Michael Coleman said Tuesday.

But the Health Care Authority raised several issues with one of the bills in a legislative analysis, saying it could “fragment” oversight and funding authority for the state’s behavioral health system.

Meanwhile, at least some efforts to expand treatment options are already in the works in New Mexico.

Clovis Mayor Mike Morris told senators Tuesday that a group of eastern New Mexico cities and counties are set to move forward with building a new crisis triage center on an 18-acre site near the Plains Regional Medical Center.

The facility would provide temporary beds for individuals dealing with mental illness or substance abuse issues to be housed before a treatment program could be determined.

Under the current system, he said most such individuals either end up in local hospital emergency rooms or in jails.

“That obviously is not as good as we think we can do,” Morris told members of the Senate Finance Committee.