BHPC General Session February 14, 2018

Present: Wayne Lindstrom, BHSD Director Karen Meador, BHSD Deputy Director Sandtina Melendrez, BHPC new member Susie Kimble, BHPC Co-Chair Cindy Collyer, BHPC Member Pilo Bueno, Presbyterian Health Plan Jackie Nielsen, ASAM Chair, BHSD Tiffany Wynn, BHSD Tammy Soveranez, BHSD Carol Luna-Anderson, BHPC Co-Chair Russ Liles, Blue Cross Blue Shield (BCBS) Health Plan Lisa Trujillo, BHPC Member Jeri Hollan, United Health Care Nancy Passikoff, BHPC Member Mark Garnand, OPRE Manager, BHSD Mark Simpson, At Large Consumer Mika Tari, BHSD Natalie Rivera, BHSD Kathy Sutherland-Bruau, Executive Director, Inside Out Mike Estrada, Department of Corrections (DOC) Anthony Futch, Aging and Long Term Services Department (ALTSD) Cathi Valdes, CPSW, Note Taker Dave Stein, Advocate (telephone) Adan Carriaga, Molina Health Plan (telephone) Art Falconer, CPSW Mari Jimenez, United Health Care Kendra Morrison, BHPC Member Anna Holiday Sharon Notah-White, United Health Care Robert Egan, Blue Cross Blue Shield (BCBS) Dorothy Carviso, DCEP Noreen Kelly, Diné Council of Elders for Peace, LC15 Verna Craig, LC15 Michael Ruble, CYFD, CASC Chair Andrea Shije, LC16 Alice King, Division of Vocational Rehabilitation (DVR), BHPC Member Matilda Fernandez, BCBS Jennifer Schwartz, Department of Transportation (DOT) Laura Bianchini, Department of Transportation (DOT) Janelle Atcitty, Presbyterian Health Plan Scott Atole, Presbyterian Health Plan Theresa Belanger, HSD/Medical Assistance Division Riqué Fernandez, CASC Member Makayla Fernandez, CASC Dorothy Waisanen, Navajo Nation Judicial Branch Shelly Begay, Molina Health Plan Monica Muera, Families ASAP Holly Chee, NASC Suzette Shije, Secretary, Indian Affairs Department Antoinette Silva-Jose, BHSD

Susie Kimble called the meeting to order.

First order of business was Introductions: Susie introduced our new BHPC member, Sandtina Melendrez from Tyrone, . She has a background as a behavioral health therapist/social worker for Kids in Need of Supportive Services and served as Director of El Refugio, Inc., which is a Domestic Violence Offender Treatment Intervention Program in Silver City. She has a Bachelors in Psychology and Sociology from Western New Mexico University, a Master’s in Counseling in Educational Psychology from New Mexico State University, and a Master’s of Social Work from Western New Mexico University.

Legislative Update: Karen Meador reported that the legislative session ends at noon on Thursday, February 15th. Bills that are still alive:  House Bill (HB) 19, Increase Penalty for Felon with Firearm, Reps. Nate Gentry and Daniel Ivey- Soto, includes language for reducing recidivism for who inmates who have behavioral health needs and connecting them to services while still in jail or prison by hooking them up to services that they need when they are discharged; how to activate their Medicaid immediately upon discharge. However, the bill has no money attached. Money in an earlier bill was included in House Bill 2, though not enough to fully implement it. (and SB73, Behavioral Health Supportive Housing, Sen. ). o Update: Passed the House and Senate. Awaiting Governor’s action.  HB97, Early Learning Advisory Council, Reps. Rebecca Down and David E. Adkins, expands requirements for recommendations by the council to CYFD. o Update: Passed the House, did not make it to the Senate floor for a vote.  HB132, Homeless Rapid Rehousing, Rep. Tomas Salazar, appropriates $2 Million to HSD to assist people who are homeless with rapid rehousing services, including case management services, life skills training, housing counseling, short term and long term rental assistance and other services that help homeless people obtain and maintain stable permanent housing; another related bill had the appropriations taken out and put in HB2; gone back to house to get agreement on HB2. Similar to SB73, Behavioral Health Supportive Housing, Sen. Howie Morales, which appropriated $2.5 million, but which did not pass either house. o Update: Bill did not pass either chamber.  HB160 Nonviolent Offender Interventions, Rep. Sheryl Williams Stapleton, changes the duties of BHSD to include a long list of things we are supposed to do for nonviolent offenders so there is a framework to reduce recidivism. o Update: Passed the House and Senate. Awaiting Governor’s action.  HB251, County Behavioral Health Transportation Fund, Rep. Sheryl Williams Stapleton, would establish a county transportation fund, but no appropriation, to allow counties to access a fund to transport people to behavioral health providers, but no money. Counties can decide if they want to contribute to the fund. o Update: Passed House but did not have a hearing in the Senate Finance Committee.  Senate Bill (SB) 4, Assisted Outpatient Treatment Act Funding, Sens. and , appropriates $1 million to Department of Health to distribute to participating municipalities and counties that have entered into a memoranda of understanding with their respective district courts pursuant to the Assisted Outpatient Treatment Act. o Update: Passed the Senate Public Affairs Committee but did not have a hearing in the Senate Finance Committee.  SB11, Guidelines for Step Therapy for Drug Coverage, Sens. , Elizabeth “Liz” Stefanics, Monica Youngblood, and Elizabeth “Liz” Thomson, have to work your way up to the more expensive medication; currently, Medicaid does not allow the MCOs to do that for antipsychotic drugs; they make look the same, but their therapeutic value is not the same. Behavioral health medications operate differently. This bill will allow for exemptions from step therapy rules, and lists a variety of reasons why you would not have to follow step therapy. o Update: Passed both chambers. Awaiting Governor’s action.  Senate Memorial (SM) 96, Services for Victims of Human Trafficking, Sens. Bill Tallman and Elizabeth “Liz” Stefanics, requests the Crime Victims Reparation Commission, the Attorney General, the New Mexico Human Trafficking Task Force, the New Mexico Tribal Task Force, the US Attorney’s Office, and the Life Link to identify strategies and policies to coordinate resources, services and housing for victims of human Trafficking. It asks them to report their preliminary findings to the Legislature on December 1, 2018; and submit a final report on December 1, 2019. o Update: Memorial has been signed into law.  SB220, “Crisis Triage Center” Definition, Sen Mary Kay Papen, corrects statutory language for both residential and nonresidential centers, allows for inpatient hospitals who want to operate a Crisis Triage Center to do so; and it has an emergency clause so it can go into effect immediately upon signature by the Governor. o Update: Passed both chambers. Awaiting Governor’s action.

Lisa asked what about Medicaid buy-in option? If your income is outside the federal poverty level, you can buy-in to Medicaid. This would be especially helpful if you have chronic health conditions. She does know the bill number. Karen Meador reported that there were two Memorials that were introduced, and passed that would explore this possibility:

 HM9, Explore Medicaid Buy-In Plan, Reps. Deborah Armstrong and Nathan Small, and SM3, Study NM Medicaid Buy-in Plans, Sen. Gerald Ortiz y Pino, both bills request that the Office of Superintendent of Insurance, the Human Services Department and other health-related agencies to provide health plan cost and coverage information to the Legislative Health and Human Services Committee. o Update: Both memorials have been signed into law.

Wayne Lindstrom asked if anyone had any other questions.

Gail: What is the new MCO?

Wayne: it is Western Sky Community Care and it is part of Centene health plan. It is a big Medicaid provider nationally.

Nancy, what about Molina and the suit against the state?

Wayne: Reality is any bidders not awarded a contract can appeal or sue. We have four MCOs and are moving to three. It is difficult assuming risk as a health plan with a small pool of patients, so having three instead of four makes them stronger financially. The protest deadline has passed. CMS approval is expected to be received in March.

Nancy: is there a safety net to pick up those currently serviced by the two that were not awarded a contract?

Wayne: there is a readiness review process for all MCOs that encompasses ten months to insure plans are ready. There will be open enrollment for Jan 1 2019 implementation date. A series of four or five public regional meetings will be held to talk about Centennial Care and the MCOs. You will get the info going forward.

Kathy S-B: Centene, aren’t they the provider of the prison system in NM? Prisons don’t have a good behavioral health system so she is concerned.

Noreen: regarding Native American community services in Indian country, what will be different for the tribes? NASC should be hearing about the changes along with the tribal leaders.

Break for lunch.

ASAM: There was a presentation by ALTSD focusing on their need to have behavioral health included in their Senior Center activities. This is a missing piece in their programming right now. Susie mentioned that we need someone from ALTSD for the council. We had an OPRE update on trainings, with 50 plus on a waiting list for training and a plan for better screening of applicants on the front end, including a competency check list for 40 hours. There is a need for peer supervision training so that agencies know how to correctly utilize peers. Rio Arriba County is sponsoring a health fair/job fair event on April 26th at Northern New Mexico College. Lisa reported on the Rio Arriba Community Health Council’s effort on “A New Normal” for combatting substance use disorder. The website is https://www.anewnormal.life/. ASAM also discussed the new Life Link project called Better Way that provides mobile outreach and employment opportunities for homeless mentally ill individuals.

CASC: Nationally, the budget passed and there is a focus on Substance Use Disorder (SUD), which means a de-emphasis on mental health that is taking a $112m hit, but no details yet. Many of the CYFD grants are under that category. Family peer support and youth peer support trainings are being planned. The Family Peer Support training will be on March 12th. The Youth Peer Support is being developed. The RFP for a drop in centers in Valencia County for youth has been issued and the RFP for a Bernalillo County drop in center is being developed, but not sure if that one is for youth. Think about how all of us can help youth to thrive, as they do not identify with the word “recovery.”

NASC: funding has been provided to Local Collaboratives and NASC has asked them how they will utilize the funding. NASC is currently discussing a Behavioral Health summit in June for Native Americans. They have a venue downtown but they will have a planning meeting to see if that will be appropriate venue with parking, etc. Native American Summits on OUD from the Tribal perspective will be held on February 22-23 in Espanola and March 7-8 in Farmington. NASC wants opportunities for LCs to talk about what they are doing and what they need, including bringing in experts from their own communities. American Indian Day was a big success.

Pilo for Presbyterian Health Plan: wraparound approach for youth and working with All Faiths will pilot with health homes too; preparing for Centennial Care 2.0—housing programs and working with justice involved populations; innovations: talk more about in April; expansion capacity for transportation system working with Superior Health; all CPSWs have to go through Mental Health First Aid; preparing for MHSIP training as phone calls are starting in June.

Russ for Blue Cross Blue Shield: innovations for Centennial Care 2.0 will include a family peer piece; wellness center project have 3 and hope to expand; Taos, Espanola and ABQ and families ASAP; Justice Department piece will be huge; identify facilities’ care coordinators and peer liaisons for background checks at the facilities for discharges; innovative housing services to see how they can partner to buy a bed or house for their members; BCBS in discussion with CYFD to do the WRAP program; peers around the state and looking at expanding that in CC 2.0.

Mari for United Health Care: peers are working on reaching transitioning youth who are coming out of Juvenile Justice Services custody; reach out to Desert Hills to develop juveniles’ skills on banking, how to build a resume, etc.; adding two new CPSWs; providing Mental Health First Aid training; involved with mayor’s task force to reach out to the community; actively works with schools to train with the parents; one middle school has a lot of homeless; suicide prevention summit in Las Cruces on May 8th with Kevin Hines; want him to speak at the schools on May 7th; new superintendent is very open to behavioral health training.

Adan for Molina Health Care: Donald works with the wellness centers including the Los Alamos mobile center and several Native American sites; also works with Courageous Transformations and Duke City Recovery Toolbox; providers treated several hundred for Hepatitis C.

All MCOs connect with members in their homes with care coordination. They all have peer support workers. Something needs to happen to provide services in Raton area. Pilo pointed out that there will be additional options for reimbursing CPSWs under Centennial Care 2.0 beginning in January 2019.

Alice King reported that DVR is going through a few changes to do expedited eligibility to get applicants eligible in a week, but can’t make them fully operational until the medical reports come in. DVR is trying to make all of the services consistent throughout the state. Currently there are differences between metro and rural.

Mike Estrada from DOC: first peer support collaboration; interventions with consumers; Narcan initiative with all the correction officers; all will carry Narcan and dispense it; round of employment classes for recovery academies; audits on the residential facilities; train the trainer for trauma informed care.