The Bernalillo County Commission will vote on a proposed behavioral health care ordinance at a meeting Tuesday. While change to behavioral health care is welcomed almost universally, the ordinance does have its critics.
The ordinance establishes the Bernalillo County Behavioral Health Authority, as well as three committees to provide assistance to and oversight of the authority.
The authority will be a central organization acting as a hub aimed at unifying behavioral health services and streamlining processes. As of now nothing like that exists within the county.
Commissioner Adriann Barboa co-sponsored the ordinance with Commissioner Eric Olivas. They pitched the change as an ordinance to provide legal weight behind their intentions to create a better system.
But the very fact that the ordinance would become law is one of the things critics said they dislike.
Commissioner Steven Michael Quezada hosted a meeting for Bernalillo County employees to give feedback. Pam Acosta is senior manager for the current Behavioral Health Initiative. She says locking these changes in could be a detriment to quality healthcare.
“Our biggest fear is again, that it is an ordinance, and we understand Commissioner Olivas and Commissioner Barboa, wants something to stand throughout time," Acosta said. "But it has to be realistic changes that don’t set us up for failure.”
During the meeting, employees said they were concerned about consolidating the Behavioral Health Initiative, and the county’s direct care services, such as the CARE campus, the state’s only free detox.
Employees say that would mean the CARE campus would have to start providing more services when it’s already stretched thin. They also said adding services could take away from space that could be used to detox patients.
Moreover, employees said they're worried about accepting Medicaid. They worry it could limit how many times patients can use detox before medicaid denies payments.
But Barboa said the move to accepting medicaid is about getting even more funding into the county’s coffers.
“To think that Medicaid is in any way limiting, no, it's expanding. Medicaid can even pay for housing, supportive housing for our families, and we've been leaving that at the table, you know. So no, there's nothing limiting about this at all," she said.
Even if Medicaid applied limits, the new deputy county manager says he would establish a policy to provide funding for those patients.
“If for whatever reason, there’s still some denial of services based on whatever reason, we need to make sure that we’ve got the safety net kind of safeguards to ensure that people do in fact get the care they need when they need it," said Dr. Wayne Lindstrom, who was recently hired to head the county’s new Behavioral Health Division.
He said that specific items don’t need to be spelled out in black and white to be a policy. Harm reduction is a perfect example, he said. It’s not listed anywhere in the ordinance, but it’s commonly used in behavioral health.
“When you're talking about prevention and early intervention, you’re really talking about harm reduction as well as a variety of other things," Lindstrom said.
Critics also say the ordinance abandons the current system for deciding where and how tax dollars will be spent on behavioral health..
The ordinance creates three new committees, including an advisory board. The board will work with the deputy county manager to develop a strategic plan, and then follow up to make sure it’s carried out.
Commissioner Barboa said the new committees will now play the role of the old subcommittees. She said they will advise, provide feedback and act as a watchdog.
“If we don't have anybody actually measuring, coming back to that strategic plan, and adjusting… it needs to be a living document that holds our county accountable to meeting needs," Barboa said.
After his community meeting Commissioner Quezada said he hopes the ordinance will be deferred so the commission can proactively address any and all concerns.
“If that doesn't happen, I will do my best to amend it, to make sure that I protect the people who are working in this behavioral health initiative in the county," he said.
Barboa said she is willing to make changes if they are necessary.
“There’s always room for amendments,” she said. “I’m not trying to force this down. If we need to do more to get it right then I am definitely open to that.”
But, she said, she thinks the ordinance has already had enough input and changes.
The measure is likely to pass. Commissioner Barbara Baca told KUNM she supports the ordinance. Her vote along with Olivas and Barboa makes the three votes necessary to pass.
The vote will be held during the County Commission’s meeting Tuesday at 5 p.m. at Alvarado Square, 303 Alvarado NE. The commission is also taking public comments online.
Support for this coverage comes from the W.K. Kellogg foundation.
Produced with assistance from the Public Media Journalists Association Editor Corps funded by the Corporation for Public Broadcasting, a private corporation funded by the American people.
