Rebuilding New Mexico's Behavioral Health Network: Annual Conference Highlights

1. New Mexico Behavioral Health Provider Association Annual Conference David R. Scrase, MD, Secretary, Human Services Department May 23, 2019

2. Governor Michelle Lujan Grisham • “David, here is your job: • Ensure that every qualified New Mexican receives timely and accurate benefits, and • Rebuild the New Mexico Behavioral Health network.” Secretary David Scrase, M.D.Human Services Department Secretary Kathy KunkelDepartment of Health Secretary Alice Liu McCoyDepartment of Aging and Long-Term Services Secretary Brian BlalockChildren, Youth and Families Department

3. Office of the governor Staff Teresa Casados Chief Operating Officer Jane Wishner Executive Policy Advisor for Health and Human Services Mariana Padilla Children’s Cabinet Director

4. New Mexico Human Services DepartmentCabinet Secretary David R. Scrase, M.D. Background • Board Certified Internist and Geriatrician • Healthcare executive in 5 > $1 billion healthcare companies in New Mexico (and Michigan) • Professor of Internal Medicine and Geriatrics at the University of New Mexico School of Medicine • Worked closely with the New Mexico Medicaid program for the past three years, leading a successful effort to enhance the treatment of Hepatitis C for Medicaid members. • Still seeing patients New England Journal of Medicine Publishes New Mexico Case Study on Medicaid Treatment Coverage Improvements for Chronic Hepatitis C Virus Study was a Collaborative Effort Between the Human Services Department, the University of New Mexico, and Medicaid Managed Care Organizations

5. New Mexico Human Services Department • Medical Assistance Division • Centennial Care • Medicaid Fee-For-Service Programs • Income Support Division • Supplemental Nutrition Assistance Program (SNAP) • Temporary Assistance for Needy Families (TANF) • School Commodity Food Program • Low-Income Home Energy Assistance Program • More • Child Support Enforcement Division • Collections • Behavioral Health Services Division • Behavioral Health Collaborative • Federal and State Funded Services for Medicaid and non-Medicaid recipients

6. 2019 Behavioral Health Legislative Highlights Support Workforce Development • HB 539 - Clarifies social work licensure requirements and allows for tele-supervision and telehealth. • SB 9 - Clarifies requirements of a conditional prescription certification to prescribe psychotropic medications. • SB 207 – Requires HSD to allow Medicaid reimbursement for Licensed Substance Abuse Associates for certain services within their scope of practice. Expand Services • HB 322 – Requires medical assistance coverage for autism spectrum disorder without age or dollars limits. • HB 43 - $2.5 million to create creation, implementation and evaluation of a behavioral health framework for incarcerated adults and juveniles with behavioral health diagnoses. Protect Provider Rights • SB 41 – provides due process guarantees for providers in fraud investigations

7. Centennial Care 2.0 Behavioral Health enhancements:potential $34 M in EXPANDED SERVICES • Individual and Family Peer Support • After hours, weekends and holiday service • Assertive Community Treatment • Comprehensive Community Support Services • Crisis Treatment Center and Crisis Stabilization • Intensive Outpatient Services • Opioid Treatment Program • Partial Hospitalization expansion/incentives • Screening, Brief Intervention and Referral to Treatment • Accredited Residential Treatment Centers • Treatment Foster Care Level I and II • Group Psychotherapy • Interdisciplinary Teaming • New modifiers for BH evaluation and management codes • Use of BH Interns in community program • Recovery services for individuals not just groups • Adding Certified Family Peer Support Worker • Expanding the types of agencies that can deliver Comprehensive Community Support Services • CareLink New Mexico, Health Home expansion Rules and structure around billing for services can be found in the new Behavioral Health Billing and Policy Manual

8. Medicaid Changes Since January 2019 • Removal of Co-payments for Centennial Care Members • Removal of Premiums for Members of the Adult Expansion Group • Reinstatement of Retroactive Eligibility

9. Maintaining Provider Network: Historic NM Medicaid Provider Rates vs. CPI (Medical) Inflated Rates

10. Medicaid Changes Since January 2019 • Proposed $60 M increase to provider rates effective July 1, 2019 • E & M codes increased to 90% of Medicare Rates (focus on BH, PCPs, and rural) • 1ST year in a 3-year plan to increase provider rates with the following priorities: • Nationally benchmarked (Medicaid RBRVS) • Annual CPI inflation • Equitable • Globally adjustable to State financial position Albuquerque Journal, May 22, 2019

11. Behavioral health collaborative priorities Hire new BH collaborative CEO, Director of Behavioral Health in HSD • Rebuild the Behavioral Health network in New Mexico (David and Alice) • Develop community based mental health services for children (Brian and Mariana) • Address Substance Use disorders in New Mexico (Kathy and new BH Director) • Draft: Address Behavioral Health issues in justice-involved individuals (Jane)

12. HSD Behavioral Health staff worked really hard to pull together these slides for me about all the great stuff we are doing right now:

14. Current HSD Leadership: Viewing of “The Shake Up”Discussion Guide • What was your general impression of the accuracy of the documentary and the level of bias? • If you had to guess, why do you think the documentary was made? • Were you here at HSD when these events occurred? If yes, please share what that was like from your perspective. • Do you believe that HSD conducted the investigation in good faith and without bias? • Do you think that HSD made any mistakes? If yes, what were they? • If you had to pick one word or phrase to describe an attitude or belief within HSD that may have been the root cause of what happened, what would you say it was? • There is a theory in psychology that beliefs form attitudes, and attitudes result in actions. What possible beliefs and attitudes may have been at the root of HSDs actions? • What personal attitudes and beliefs might each of us have, or that HSD still has, that would put us at risk for repeating the past? • Are there any proactive actions we can take to rebuild trust with the behavioral health community in New Mexico? • Are there any proactive actions we can take to rebuild the behavioral health network in New Mexico? • Any other comments or observations?

16. Can we just talk? • What can HSD do to re-establish trust with the New Mexico Behavioral Health provider community? • What can HSD do to rebuild the New Mexico Behavioral Health provider community?

17. Feel free to contact me • david.scrase@state.nm.us • 505-316-5422 (text name and message if no answer)