Santa Fe County Health Action Plan FY 2015-2017

Santa Fe County Health Action Plan FY 2015-2017 Summary of County Government Planned Actions and Actions taken Goal 1: Increase Enrollment of Santa Fe County Residents in Health Insurance

County Government Planned Actions County Actions Taken 1. Partner with Project Access and primary 1. The County and its partners have coordinated in enrolling people into care providers to coordinate outreach and health insurance or Centennial Care/Medicaid. The Community enrollment in Centennial Care/Medicaid Services Department has participated in outreach events in the and the New Mexico Health Insurance community, including at CHRISTUS St. Vincent, WIC offices, local Exchange (NMHIX). churches, and with NMHIX. 2. Provide information, in both English and 2. Materials are widely available to County residents on enrolling in Spanish, about enrolling in Medicaid and Centennial Care/Medicaid and the NMHIX, through the Health Care NMHIX on County website, with links to Assistance Program. NMHIX website and locations where 3. Through a contract with La Familia, outreach and enrollment in English primary care providers are doing and Spanish was conducted in rural parts of the County as well as with enrollment. people who are not documented and meet certain criteria for 3. Enter contract to do outreach and enrollment. enrollment in rural Santa Fe County, in 4. The Community Services Department is working to ensure that both English and Spanish. increased numbers of people receive information about how to enroll 4. Create information blasts that reach all through radio ads, in both English and Spanish. For example, In FY communities in the County using print and 2015, through a grant from the New Mexico Association of Counties, radio, in English and Spanish. Hutton Broadcasting ran 120 spots on KLBU/Juan Spanish station, for 5. Utilize Mobile Health Van to disseminate an estimated reach of 36,000 Spanish listeners, and Radio KRZY ran information. 114 spots, for an estimated reach of 400,000 Spanish listeners. 6. Increase capacity at County Corrections to 5. Increased numbers of people have received information through the enroll inmates into Medicaid prior to their Mobile Health Van, including through piggy-backing with NMHIX release. enrollment events held at Fort Marcy, Southside Library, and the 7. Train County staff to do Medicaid Genoveva Fitness Center. enrollment and integrate enrollment into 6. The Community Services Department provided funding for the hiring DWI process. of personnel at Corrections to ensure that all eligible detainees are enrolled into Medicaid prior to release. 7. The Health Care Assistance Program staff at Community Services Department has been trained to do Medicaid enrollment for the community, and has enrolled two individuals to date. Staff is also working with DWI and Teen Court to integrate enrollment into those programs. 1 Santa Fe County Health Action Plan FY 2015-2017 Summary of County Government Planned Actions and Actions taken

2 Santa Fe County Health Action Plan FY 2015-2017 Summary of County Government Planned Actions and Actions taken GOAL 2: Reduce Alcohol Abuse

County Government Planned Actions County Actions Taken 1. Complete the evaluation of the Screening, 1. The Community Services Department’s DWI Program has selected an Brief Intervention, and Referral to evaluator for the SBIRT pilot and expects to have a contract in place in Treatment Pilot (SBIRT) and work with May 2016. A second contract, with Behavioral Therapy Associates, will community partners to expand SBIRT provide for a web-based application of SBIRT for all DWI offenders. initiative with DWI offenders. 2. The Community Services Department’s DWI program has worked 2. Advocate for best practice regulation of closely with the Santa Fe Prevention Alliance to address alcohol alcohol outlet density. density issues, including (1) advocating for the ban on miniature bottles of alcohol, which passed the Santa Fe City Council (but later 3. Support law enforcement in increasing the was overturned by the state Supreme court), and (2) advocating for number of checkpoints and saturation denial of Walmart’s application for a liquor license on Cerrillos Road, patrols. which was denied by the Santa Fe City Council. An additional 4. Work with SID, SFPD, SFPA and other law legislative issue, increasing the alcohol excise tax in New Mexico, is enforcement agencies to reduce over- the subject of a contract with the Santa Fe Public Schools. serving and access of alcohol to youth 3. County DWI grant funds were provided to conduct checkpoints and through enforcement operations and saturation patrols. During 2014 and 2015, 52 checkpoints and 84 saturation improved public awareness. patrols were conducted. 5. Increase public awareness campaigns on the consequences of binge drinking and 4. The Santa Fe Prevention Alliance conducted operations with the Santa DWI (including audiences who lack Fe Police Department and the Special Investigative Unit to target experience with the legal or treatment under-age drinking through “party patrols,” which seek out parties systems such as immigrants and young where underage drinking is occurring. In collaboration with local adults). student wellness action teams, Sticker Shock campaigns were conducted, placing warnings on alcohol packaging in stores advising 6. Collaborate with treatment providers to that purchasing alcohol for minors is a fourth degree felony. In increase access to both substance abuse addition, the Community Services Department‘s DWI program and behavioral health services for DWI provided $5,000 to the Special Investigative Unit to conduct over- offenders. service operations, with agents entering bars and observing and issuing citations to bartenders for overserving patrons. 7. Collaborate with SFPA to reduce adult and 5. The Community Services Department’s DWI program conducts large- 3 Santa Fe County Health Action Plan FY 2015-2017 Summary of County Government Planned Actions and Actions taken underage drinking and continue to fund scale public awareness campaigns focusing on binge drinking and DWI evidence-based prevention efforts in (the “Two Too Many campaign), including in local newspapers, on the schools. radio, bus wraps on the sides of city buses, and in establishments where liquor is served. In addition, through working with the courts, 8. Coordinate underage drinking prevention a urine testing program has now been implemented for all convicted efforts with Juvenile Probation and Parole by DWI offenders, an approach that has been shown elsewhere to reduce supporting the Restorative Justice Program for binge drinking. Working with the New Mexico Crisis Hotline, a pilot youth and working with the Juvenile Court to program will be aimed at helping family members deal with loved ones develop effective family interventions that who have an alcohol addiction and get behind the wheel. work to break the generational cycle of abuse. 6. The Community Services Department ‘s DWI program, through its DWI compliance officers, works to ensure that convicted DWI offenders are receiving appropriate treatment services, by tracking their participation in court-ordered treatment with Santa Fe Recovery Center, Life Link, Southwest Counseling Center, and individual therapists. The program has entered into a Memorandum of Understanding with Tesuque Pueblo to provide compliance monitoring services for DWI offenders sentenced in their Tribal Court. A similar MOU is planned with Pueblo of San Ildefonso.

7. The Community Services Department ‘s DWI program contracts with the Office of Student Wellness at the Santa Fe Public Schools to provide evidence-based curriculum in class for students in fourth, fifth, and sixth grade. An additional contract supports Student Wellness Action teams, which are peer-run groups of junior and high school students. The Student Wellness Action teams host alcohol-free events and participate in DWI Day at the Legislature, speaking with state legislators, as well as advocating for measures such as the ban on miniatures, before the City Council.

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Goal 3: Reduce Drug Abuse

4 Santa Fe County Health Action Plan FY 2015-2017 Summary of County Government Planned Actions and Actions taken County Government Planned Actions County Actions Taken 1. Increase the number and quality of 1. The Community Services Department provided funding to La Familia for physicians authorized and trained to training of physicians in the prescribing of suboxone. prescribe suboxone in the County. 2. The Community Services Department contracted with La Familia in the 2. Fund increased capacity to provide amount of $158,000 to provide medication-assisted treatment for medication-assisted treatment (MAT) in pregnant women who use opiates. This has resulted in 46 women to date the County. receiving such treatment and giving birth. Of these babies, 39 were of 3. Convene group to understand current healthy birth weight and born full-term. In addition, the Community policy on Narcan use and any other Services Department has funded a public awareness campaign to increase evidence-based interventions to reduce the number of pregnant women who use opiates that are enrolled in deaths from overdose. treatment programs. Finally, the Community Services Department’s 4. Continue to participate in Santa Fe Health Care Assistance Program reimburses providers for substance abuse Opiate Safe work group and Law treatment, including medication-assisted treatment. Enforcement and Assistance Diversion 3. The County participates in the statewide overdose prevention group with Task Force. representatives from DOH and other neighboring counties (Rio Arriba, 5. Work with County Corrections to Taos, Bernalillo and Dona Ana) that includes discussion of Narcan use and develop program for education and interventions and acts as a think tank to inform statewide Narcan and distribution of Narcan upon release. drug policy. The County Sheriff’s Office has trained its deputies in the 6. Hold regular drug take back days. use of Narcan. In addition, Narcan kits are distributed by County Corrections to inmates upon their release, and the inmates and their 7. Increase the capacity of the Mobile families have been educated in the use of Narcan. Finally, Narcan kits are Health Van to do harm reduction. distributed through the La Familia medication-assisted treatment 8. Work with law enforcement agencies to program. To date, close to 100 Narcan kits have been distributed through install permanent lock boxes for that program. prescription drugs. 4. The Community Services Department continues to partner with the Santa Fe Prevention Alliance to support the activities of the Santa Fe Opiate Safe work group. This group has identified increasing the use of the Prescription Monitoring Program by area prescribers as an important goal for changing prescriber behavior to better control unauthorized access to opiates. A conference will be held to educate providers, especially high prescribers, about the importance of using the Prescription Monitoring Program and other best practices. The Community Services Department continues to participate in the Law Enforcement and Assistance Diversion

5 Santa Fe County Health Action Plan FY 2015-2017 Summary of County Government Planned Actions and Actions taken Task Force, and provided funding for a process evaluation of the program. 5. A “re-entry specialist” has been hired at County Corrections, whose responsibilities include education and distribution of Narcan kits to inmates and families. 6. Since April of 2014, the County has organized, in collaboration with the Drug Enforcement Agency, three drug take back days at area locations including police stations, fire stations, and shopping centers, collecting over one thousand pounds of unused prescription drugs. Note that the DEA will no longer collaborate and dispose of these drugs, so no further take back days are planned. Instead, the focus is now on getting pharmacies to take back drugs, as well as on permanent lock boxes where people can drop off unwanted drugs. 7. The nurses on the Mobile Health Van have been trained in harm reduction, both with Narcan and with existing syringe exchange programs. Narcan is now available on the Mobile Health Van for use by the nurses in case of emergency. 8. The Santa Fe Opiate Safe work group, in which the County participates, provided support for the installation of permanent lock boxes, which have been set up at the City of Santa Fe Fire Station #1 on Murales Road and at the City of Santa Fe Police Department.

6 Santa Fe County Health Action Plan FY 2015-2017 Summary of County Government Planned Actions and Actions taken GOAL 4: Reduce Low Birth Weight

County Government Planned Actions County Actions Taken 1. Support expansion of home visiting 1. The Community Services Department funded a low birth weight services and/or other evidence-based prevention initiative in the amount of $250,000 in FY 2015, through services that address low birth weight in contracts with La Familia ($185,000) and Las Cumbres ($65,000). the County. These contracts are renewable for up to four years total and support outreach to teens for family planning, home visiting, and case 2. Disseminate information about current management for at-risk pregnant women; screenings and referrals to programs and services available for address risk factors; prenatal education, nutrition, and smoking prenatal care across the County. cessation classes; and group prenatal visits. 2. 3. Fund a community-based program for The La Familia and Las Cumbres low birth weight prevention programs include public awareness. In addition, information about current medication-assisted treatment (MAT) programs and services available for prenatal care through Department services for pregnant women addicted to of Health was presented at a Health Policy and Planning Commission opiates. meeting in 2015. 4. Create public awareness campaign and 3. The Community Services Department funded a contract with La Familia outreach efforts for pregnant women in the amount of $158,000 to provide medication-assisted treatment addicted to opiates. services for pregnant women who use opiates. This has resulted in 46 women receiving such services and giving birth. Of these babies, 39 were of healthy birth weight and born full-term. 4. Together with La Familia, the Baby Fund, and CHRISTUS ST. Vincent, the Community Services Department collaborated on a public awareness campaign and outreach efforts for pregnant women addicted to opiates. The dissemination of awareness campaign materials was coordinated with Santa Fe Opiate Safe.

GOAL 5: Reduce Suicides

County Government Planned Actions County Actions Taken

7 Santa Fe County Health Action Plan FY 2015-2017 Summary of County Government Planned Actions and Actions taken 1. Work to increase enrollment in 1. The County Public Safety Department hired a re-entry specialist, initially Centennial Care/Medicaid for those with using funds from the Health Care Assistance Program, to ensure that all mental health issues. detainees are enrolled in Medicaid prior to their release from the County jail. 2. Incorporate mental health screening into Mobile Health van activities. 2. Mental health screenings and appropriate referral have been provided through the Mobile Health Van, in collaboration with CHRISTUS St. 3. Develop a resource guide for mental Vincent. health service in Santa Fe County. 3. The County is working with the Behavioral Health Services Division, 4. Hold a joint depression screening day which is launching a network of care web-based portal to include with CHRISTUS St. Vincent. resources for behavioral health services in Santa Fe County

5. Work with Corrections to increase 4. Three dedicated “mental health screening days” have been held at Santa resources for discharge planning. Fe Community College, in collaboration with CHRISTUS St. Vincent therapists, and more are scheduled for May 2016. 6. Work with the courts, DAs, Public Defenders, jail staff, providers and others 5. The Community Services Department Health Care Assistance Program to insure access to a continuum of care. provided $300,000 in funding to the Department of Public Safety to fund (a re-entry specialist/case manager at the Adult Detention Facility, to 7. Coordinate with local behavioral health prepare people for transition from the facility into the community, collaborative. including discharge planning and an intensive case management 8. Promote planned activities for Mental program for individuals diagnosed with a severely disabling mental Health Awareness Month. illness and who are reintegrating in to the community.

6. Continued participation in the Behavioral Health Alliance and consider 9. Increase access to state and local suicide recommendations emerging from this group, including incorporating hotline call-in numbers throughout the mental health training and mental health professionals into First County. Responder Systems.

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8. The mobile health van participated in community activities during Mental Health Awareness Month and held a mental health screening day at Santa Fe Community College.

9. The Community Services Department funded the creation of the Mobile Crisis 8 Santa Fe County Health Action Plan FY 2015-2017 Summary of County Government Planned Actions and Actions taken Response Team, with Presbyterian Medical Services (PMS), dedicated to assisting first responders with people in behavioral health crisis, and providing follow-up case management to connect them with appropriate resources. The $350,000 contract, which is renewable for up to a total four years, also funds the PMS crisis line to be used in conjunction with the Mobile Crisis Response Team. In addition, the Community Services Department publishes suicide hotline call-in numbers in the Family Resource Directory, in both English and Spanish, with thousands of directories distributed each year.

9 Santa Fe County Health Action Plan FY 2015-2017 Summary of County Government Planned Actions and Actions taken GOAL 6: Increase Consumption of Healthy Food

County Government Planned Actions County Actions Taken 1. Along with the City, provide funding for 1. The County Community Services Department budget includes funds for the Food Policy Council Food Policy Council, which were increased in FY 2015 to $25,000 and 2. Support state legislation for New Mexico are continuing at $25,000 in FY 2016. grown fresh fruits and vegetables for school meals, and advocate for state 2. The Board of County Commissioners passed a resolution in support of funding. state funding for New Mexico Grown Fresh Fruits and Vegetables for 3. Provide free or subsidized meals to School Meals in November 2014 and again in November 2015. The seniors, both to homebound and at senior County made this one of the County’s legislative priorities for the 2015 centers. New Mexico State Legislative Session and actively lobbied for passage, 4. Provide education on nutrition to seniors. along with partners including the Food Policy Council, resulting in a 5. Integrate fresh food into meals provided at state appropriation of $364,300 for FY 2016. SFC senior centers. 3. The number of meals delivered to homebound seniors via the 6. Support community gardens at senior Community Services Department’s increased to 51,192. The number centers. of congregate meals served at senior centers increased to 40,317. 4. Every quarter, the Community Services Department’s Senior Services program provides nutritional education materials, including recipes, to seniors at all seven senior centers, and also brings the nutritional material to people who receive home-delivered meals 5. In FY 2015, 53 percent of produce served through senior centers was fresh, with frozen used primarily when fresh produce was either not available or not practical. 7. The community gardens at Eldorado and at Edgewood provide fresh produce for seniors to take home with them.