By Mary Alice Murphy

The Grant County Community Health Council held its regular bimonthly meeting on March 12, 2018. The change of date facilitated presentations by the area's New Mexico state legislators. Judy O'Loughlin, co-chair, moderated the meeting.

Sen. Howie Morales, District 28, was the first to speak.

"Thank you for the opportunity to give you an overview of the recent session," Morales said. "It's so nice to be home. It was a good session. We finally had a surplus, but we were conservative. We got our state reserves from 1 percent back up to a healthier 10 percent."

He said it was the best session he had seen in the 11 sessions he has participated in as a senator. "Right off the bat, we jumped in with the nursing licensing compact issue. It could have brought health care throughout the state to its knees. It's a compact with 26 states. New Mexico had not renewed the compact. We had up until Friday of the first week of the session to get it signed. It was SB1."

"The nurses at Gila Regional Medical Center tipped me off in June or July, so I carried the legislation," Morales said. "It wasn't easy, but we got it done and signed on Thursday. Then we went right into the budget. It was so nice we didn't have to talk about cuts. We added money to education."

He said the state financial situation is still volatile because it is so dependent on the oil and gas industry. "We approved a $6.3 billion budget and kept 10 percent in reserves. In early childhood, we added $34 million. We also added more to Medicaid, which will bring us a 4-to-1 match from the federal government."

"Another issue was what could have taken place for seniors," Morales said. "We averted a huge crisis. The governor's office was going to cut off the contracts on February 1. It would have impacted congregated meals for 75,000 seniors. Two weeks into the session we got the contract cut-off rescinded. So, we know it won't be abrupt. We don’t want a sudden cut off like happened with mental health care throughout the state. Priscilla (Lucero, Southwest New Mexico Council of Governments executive director and Health Council member) gave me information to help head it off."

An auto-theft bill was Albuquerque's priority, because the city is No. 1 in the state for stolen vehicles.

"We put money into Senior Olympics," Morales said. "New Mexico is host to next year's national Senior Olympics event. It was a pretty productive year."

He said the county got some capital outlay, with the only item vetoed being a new backhoe for Hurley. "We managed to increase from $4 million to $6 million for Western New Mexico University, as well as additional funding for Silver and Cobre schools for information technology. The organization work of Prospectors in Grant County helps us out to justify our legislative requests."

"We are still nowhere near where we should be in New Mexico," Morales said. "We are 49th in child well-being; 50th in education and high in crime. We need to make improvements. What we can do is to be not so reliant on oil and gas, as well as copper. We need renewable energy—wind, solar and explore the possibilities of algae. I continue to push for renewables. I am honored and blessed to serve as your state senator. I don't know what the future will hold."

He noted that Health Council Member Magistrate Judge Maurine Laney has been advocating for the courts. "We need a well-balanced approach to crime."

Health Council Member Jim Helgert said New Mexico is 49th in child well-being. "In a psychological testing, one of the questions was does the child live in New Mexico. So, it's a factor just living here."

Morales said he and the two representatives, Rebecca Dow and Rodolpho "Rudy" Martinez work as a team. "We always agree on what is best for our area. We do have a strong team. There aren't many of us, but with Rep. Candie Sweetser and Sen. John Arthur Smith, we do our job banded together."

Member Terry Anderson said: "We can tell you are working for the region and the state."

Rep. Rebecca Dow District 38, thanked the council for the invitation. "I'm privileged to be on the Health Council in Sierra County. I was happy to support the memorial for health councils. We didn't have as many bills in the 30-day session. We had a lot more memorials than bills, with 75 memorials signed. We did important work around guardianship for seniors. A memorial was for food security for seniors. It's important that the food contract was kept for the seniors, but they are going out to bid again in June and might not keep the same vendor. In the southern part of the state, we are reimbursed for meals substantially less, some fewer than $3 a meal, but it's up to $15 in the northern part of the state. We cannot have one day without food security for our seniors."

She said behavioral health and mental health issues affect seniors, as well as the opioid and substance abuse issues. "In order to take away some of the issues with substances, the state is working on other options for pain management, but at the same time they are taking the medications away from seniors just like that. They've been on it for years and you get a call. They don't have an alternative for their pain treatment. They're in pain, they're scared; they don't know what they're going to do. We did pass a bill for the Drug Council to address pain management. I think it's going to be critical. The fact we didn't have any cuts to Medicare and Medicaid was a big one this year."

As far as economic development, "we were able to keep JTIP, LEDA and the small business development centers funded. They stayed whole. I think there are some opportunities for Grant County with the Solo Worker initiative that was funded. A total of $60 million was allocated for roads, which gives us some opportunities."

Dow said she would continue working on watershed restoration. There have been suggestions that, because it is slow work for archaeologists to walk areas to find ruins and items that need to be saved, modern technology, such as using satellite images and drones would save time and open up more contract work.

She noted a number of memorials passed that addressed health care issues. Centennial 2.0 will no longer have Molina and United as providers as of the end of June. "Those who are insured under them can start changing to other providers now instead of waiting until June. We did expand home visits through Centennial 2.0. We put in $250,000, which will leverage to $1 million."

"There's a lot to be proud of in Grant County," Dow said. "The Extension Office provides not just the traditional services, but also consumer science classes. It's always fun to have the 4-H and FAA students in Santa Fe. It's clear that agriculture is important in Grant County. The southwest district is in need of younger folks. We need to make sure we have jobs here, so they can stay."

The Legislature raised court pay rates, in a bi-partisan manner, but Bernalillo County will get more than anyone else. She said it raises a problem for law enforcement in rural areas to keep their officers, because of higher pay in other areas. "Albuquerque is No. 1 in car theft in the nation."

"I really believe in prevention and early intervention, so we don't see kids end up in prison," Dow said. "It's a huge area in need of reform. I have a soft spot for kids at risk. Did you know that 80 percent of the kids in prison were raised in foster care? It's sad to hear that Bianca (Padilla of the JPPO (Juvenile Probation and Parole Office) has moved on. She had some great ideas. I am talking to CYFD (Children, Youth and Families Department) to fill the position."

She said she will continue to advocate for rural areas. "We got $25 million for subsidized child care, but it won't do much good without facilities that meet regulate ons. I'm trying to get waivers on sunlight, window height and such. One can get waivers, but it isn't easy, and they don't give out many."

Dow said $8 million will go to expanding Pre-K, and Kindergarten Plus will go back to where it was before the cuts. Imagination Library received funding to expand throughout the state. She said $250,000 went to Medicaid. "A lot more funding is going to workforce expansion. We have found out that early childhood programs, if not a quality program, can do more harm than good."

She noted that regulations do not allow three-year-olds to be put in classes with four-year-olds. "Mixed-age groups are against the rules. Montessori supports mixed-age groups, but they are private. Again, very few waivers are granted. I've been fighting for combined age groups. Especially in rural areas, early childhood classes in Cliff can't find 20 three-year-olds, for instance. A proposal for a pilot project for mixed ages is on its way."

"The groups have to be affordable and sustainable," Dow said. "When there is no option, it drives up costs."

She also noted that more movement into renewable sources of energy will prevent growth in the Permanent Land Grant Fund, so it should not be raided.

Dow said so many memorials addressing behavioral health were passed during the session, that during the interim, bills will be developed for next year's 60-day session.

Yucca Lodge, which provided behavioral health and substance abuse treatment, closed I Grant County in order to move the services to Roswell. "But it still is not open in Roswell. I talked to the secretary about opening something here."

She said the Fort Bayard Medical Center is not self-sufficient and it is proposed to make it long-term care for veterans to have federal stable revenue to make it sustainable at Fort Bayard. "But that hasn't happened either. If it will take $50,000 to remodel and make it sustainable and provide beds for veterans, I would get on it right away, but that didn't happen in this session either."

"I want to know what the plan is for Tu Casa, now that there is no detox," Dow said. "We have to keep our eyes on things."

One of the biggest indicators for all these issues is poverty. "Commitment to economic development is critical. We have to find revenue to address workforce development and jobs for people. We have to turn the curve on poverty."

Helgert said Tu Casa will have social detox, but not medical detox. "And there is no residential at this point. We're talking with HMS on how we can do a step-down process and have a place for them to stay so they can go back into the program during the day."

"There's no way to fund this because this isn't billable, so we need to put our heads together and come up with some creative solutions," Dow said.

Edith Lee, alternate for HMS CEO Dan Otero, said she is not only support services for HMS, but is also a mental health clinician. She said the Department of Health presented recently to the health council and "the suicide rate is particularly high in Grant and Hidalgo counties. One of the best prevention recommendations is mental health First Aid. Why are law enforcement personnel required to know physical First Aid, but not mental First Aid? I encourage you to take back to the Legislature that mental First Aid is a great prevention measure."

"It's typically a full eight-hour day for the training," Lee said.

Dow said the House passed a requirement for training for ACES (adverse childhood experiences) to address poverty, but it died in the Senate. "We need to get together and determine all the requirements for training, and which ones are needed or could be consolidated."

Rep. Rodolpho "Rudy" Martinez, District 39, said, he as a former Health Council member, especially appreciated the invitation to share his perspective on the recent legislative session.

"I understand your needs," Martinez said, "not just here in Grant County, but throughout the state. I, as a member of the Appropriations Committee, was in Santa Fe the week before the session to help create an appropriations bill. We had no cuts this year and got our reserves back up to 10 percent. The budget we created was bare and equitable. We got some raises this year for state employees, teachers, law enforcement and judges. So far, the only raises vetoed were for the governor, the lieutenant governor and state agency heads. They have had no raises since 2002. Memorials have no teeth, but they bring up issues. Several addressing behavioral health, child care and education issues were passed. The big question was seeking to take 1 percent more from the interest received by the Permanent Land Grant Fund. It contains $22 billion, but many feel it should remain and continue to provide the amount it does for education. The flip side question was how to fund pre-K. There are other funds, such as the Tobacco Fund that are held in state trust. I co-sponsored a bill to increase the population limits for those entities that will continue to be affected with the phase-out of hold harmless funding. Those municipalities with 10,000 or more population continue to lose hold harmless funding, [which was brought in to help smaller communities who were impacted when the food tax was removed]. My bill would have increased the limit to those over 25,000 population. The bill did not go through. The other bill I carried was the Southwest Water Projects bill to take money out of the New Mexico Unit Fund. It was contentious and controversial, and it died in committee. We are trying to set up meetings to see what we can do locally about the regional water plan and 24 other projects in the four counties."

He said he has also been working on guardianship issues to allow grandparents, who are raising their grandchildren, to be able to enroll the children in school, K-12. "New Mexico does not have a statute that grants grandparents rights."

Martinez said rural communities are now called frontier communities. "Some, especially in the native areas, don't have running water or utilities The Frontier Community Challenge work group is working on the issues. I co-sponsored it with Sen. Cisneros."

He said broadband is desperately needed in tribal areas. There is a company providing the equipment, but maybe the house doesn't have electricity. Solar is helping.

On the topic of veterans [Martinez serves on the Military and Veterans Affairs Committee], the state provides extensive behavioral health services for veterans.

"I also supported educational efforts for future veterans," Martinez said. "The Naval Education Fund provides Naval Reserves in addition to ROTC in high schools."

He said, too often, people misrepresent themselves as having had military service. "Unfortunately, we see it at street corners. Sometimes, they take advantage by wearing a uniform, and they actually haven't served. I supported stronger legislation to prevent the misrepresentation."

"I know we don't have very many elevators in Grant County," Martinez said, "but areas that do have elevators found they were not being inspected often enough."

He said: "It was a good session. We had good dialogue among us. Grant County received some money, as did Western New Mexico University, Santa Clara, Silver City and Bayard, which each received some, but not Hurley for a backhoe to replace the one that is falling apart. It was vetoed. There were a number of other memorials and joint memorials. They bring out the issues and needs of communities. It was a good year, with no cuts and almost everybody received some funding. Teachers will receive $2,000 more a year and a 2.5 percent increase to state employees. It's not sufficient, but it's something. We made an effort to fund a primary caregiver residency program. We are fortunate to have one here at HMS. The Center for Health Innovations is active in issues. A hospital in Alamogordo is signing on to provide primary care to rural areas. I was busy with the appropriations committee and other committees, but it is all worthwhile."

Health Council Director Cari Lemon asked about broadband. Martinez said some legislation was sponsored by the Native American legislators, but the governor vetoed $2 million in projects for them. "We're all aware of the broadband needs and are supportive."

Kathleen Hunt, Health Council member, representing behavioral health, thanked Martinez for working "tirelessly for veterans. If you could do something about the Truth or Consequences facility, we would be so appreciative."

Martinez said they had looked for a bus to take people from Las Cruces to T or C, which is a nice new facility for dementia and Alzheimer's, but the governor "decided it was pork and vetoed the funding for the bus." He said the director for South Central Transit is looking for federal funding. "The T or C folks support the facility1000 percent. They are having a problem with staffing. They were working for the bus for free transportation for those who might want to work out of Las Cruces, particularly CNAs. We will have to step back and decide how to provide staffing."

"We have providers here, but not specifically for veterans," Martinez said. "Thank you for having us here today. If you have questions, call me or any of us and we'll be happy to find answers for you."

In her director's report, Lemon said she is working with the New Mexico Direct Caregivers Coalition to provide training in Grant County. "I got a contract, but it was in my name, so I asked if it could be in the name of the Health Council, and I haven't heard back. Could it be in my name and I would still represent the Health Council?"

Lucero suggested she go to the agency where the funds originate. "When you deal with federal funds, there are a large number of requirements. Be cautious. I'll look into it, so we can determine whether it's a good idea. We want to protect you and the Health Council."

Lemon said she is moving forward with SHARE New Mexico to host the Grant County Health Council Resource Directory.

On the Community Health Assessment, Lemon said she had talked to the Department of Health epidemiologist in charge of assessments, and she said a return of 400 assessments would give a good overview, but to not be biased, and that it was about being diversified.

"April 1 is the start date with the end date of August 1," Lemon said. She asked each member to give her a list of what groups they can disseminate the assessments to. After the assessment is complete and all the data have been compiled, health council members will determine priorities and how to approach them.

She then handed out assessments to the members to be the first testers to find any problems, so they could be fixed before going public.

Hunt announced an opening at Border Area Mental Health Services for a case manager for juveniles.

O'Loughlin announced the My Chronic Disease and Pain Management course would begin at the Extension Office on March 22.

The meeting adjourned.

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