Finding help: San Juan County focuses on increasing access to behavioral health care
Officials view $500k state grant as a starting point
AZTEC — San Juan County officials know residents have a lack of access to behavioral health care. They say it can take up to 60 days to get an appointment with a behavioral health professional.
A nearly $500,000 grant from the state will help the county provide behavioral health care for a small number of people in the community who need it — approximately 50 incarcerated individuals who have been at the San Juan County Adult Detention Center four or more times in a single year.
County officials view the $493,000 grant as a start. The grant will not only allow a group of inmates to receive treatment while incarcerated, it will also provide assistance after they are released. That assistance will include access to medication, transportation to appointments and the possibility of housing.
Presbyterian Medical Services will work with the county to administer the program and bring the resources together.
County Manager Mike Stark said the hope is that the behavioral health care will reduce the reincarceration rates for those 50 people.
Reducing reincarceration will save taxpayers money
That is important because San Juan County spends about 32 percent of its budget for the detention center on medical and mental health care. The contract it has to provide those services is the county’s single largest contract. Stark said the county will likely spend $5.3 million this year on medical and mental health care at the detention center.
San Juan County’s entire budget for the detention center is more than $17 million.
Stark said the average daily population at the adult detention center is 650 individuals. Those people can get mental health care within seven days of being booked into the detention center.
Stark said the facility has become a de facto mental health care center.
County Commission Chairman Jack Fortner said having people in mental health crisis being arrested or going to the emergency room to receive help can lead to problems for those individuals. He said people in crisis will sometimes lash out at the detention center or emergency room staff members. That could lead to them facing felony charges for battery on a peace officer or health care worker.
Stark said the goal is to be proactive and intervene early on. He said early intervention likely will save taxpayers money in the long run.
“You’re paying for it as a taxpayer one way or another,” he said.
Behavioral health care initiatives go beyond the incarcerated
This initiative is just one way that the county hopes to improve quality of life by increasing access to behavioral health care.
“When I came on board, I heard people say we’ve talked about this for a number of years, but we’ve never done something about it,” Commissioner Jim Crowley said.
San Juan County contracted with MAS Solutions LLC and Ericson Consulting to study the gaps in the behavioral health care system. The report was released earlier this year.
Crowley marked on his copy of the report a section where it states the highest-priority recommendation is that the county immediately hire a director for the system. The county is in the process of hiring that director right now.
Other recommendations included expanding the Joint Intervention Program, partnering with universities and expanding treatment court.
Crowley said there has been a misconception that the county will be giving out money to providers to increase access to behavioral health care. He said the county cannot afford to do that.
The county also has compiled a guide to help people find behavioral health care providers. It even provides a map on its website to clinics in Farmington.
Fortner said the county is also trying to increase awareness about mental health and substance abuse.
“The sooner we increase awareness, then the stigma that surrounds mental illness will go away,” Fortner said.
Low Medicaid and Medicare reimbursement rate impacts who receives care
Fortner said the county knows the incarcerated population is just a subset of a larger group of people that needs access to behavioral health services. His answer to the lack of access is that the county needs more behavioral health care professionals, and those professionals need to be paid more. That includes increasing the reimbursement rates for people who treat Medicaid and Medicare patients.
Fortner said his wife is a psychiatric nurse practitioner and stopped seeing patients who rely on Medicaid and Medicare because the reimbursement rate was too low.
That is problematic because nearly 44 percent of insured people in San Juan County rely on Medicaid, according to the Behavioral Health Gap Analysis.
Fortner, Crowley and Stark met with Gov. Michelle Lujan Grisham earlier this year and discussed those challenges. Fortner said the governor is committed to increasing the reimbursement rates and the county will support her effort. He said her initiative is crucial to the county’s plan.
Hannah Grover covers government for The Daily Times. She can be reached at 505-564-4652 or via email at firstname.lastname@example.org.
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