NEWS UPDATE: ON FEBRUARY 27, 2025 GOVERNOR MICHELLE LUJAN GRISHAM SIGNED INTO LAW THE BEHAVIORAL HEALTH CARE REFORM PACKAGE
On February 22, the New Mexico legislature gave final approval to 3 Senate Bills that will make sweeping changes to how New Mexico’s mental health and drug abuse treatment programs are run statewide. All three bills taken together are known as the Behavioral Health Reform Package. The following is a description of each of the enacted Senate Bills:
Senate Bill 1: This bill creates the Behavioral Health Trust Fund for the state of New Mexico to support mental health and substance abuse treatment, prevention, and intervention programs throughout the state. The behavioral health trust fund will be invested by the State Investment Council. The trust fund will distribute 5% of its annual value to fund the programs and support investments in necessary infrastructure, technology, and workforce development to facilitate the expansion of services. The fund could also help New Mexico unlock matching funds from federal, local, and private sources. One major change made to Senate Bill 1 was removing a $1 billion appropriation for the new proposed trust fund. Money for the new fund is now expected to be provided in a separate budget bill during this year’s 60-day session.
Senate Bill 2: This bill allocates $200 million to expand regional behavioral health services such as crisis response and outpatient care. The bill appropriates the funding to the New Mexico Administrative Office of the Courts and various state agencies to set up a new framework for behavioral health programs statewide.
Senate Bill 3: This bill requires regional plans be crafted for providing mental health and substance abuse treatment. The plans would be overseen by the state judicial branch and would include time lines and regional funding priorities.
The Behavioral Health Reform Package now goes to the Governor’s desk to be signed into law.
The Behavioral Health Reform Package had a total of 19 bipartisan sponsors, led by Senators George Muñoz (D-Gallup) and Liz Stefanics (D-Cerrillos). During the 2025 Legislative session, House and Senate Democrats worked together to make record investments in behavioral healthcare and substance use treatment programs to give New Mexicans the help they need when they need it. Speaker of the House Javier Martínez (D-Albuquerque) said this:
“Throughout the interim, we worked closely with our colleagues in the Senate to develop a multi-faceted plan to address our state’s behavioral healthcare needs and improve public safety statewide. … This session, we have worked quickly and thoughtfully to deliver on our promise to advance meaningful legislation that will make our communities safer right away and address long-standing gaps in services for this generation and the next.”
Both Democratic Majority Floor Leader Senator Peter Wirth and Republican Minority Floor Leader Senator Will Sharer voted for all three Senate bills.
Democrat Sen. Peter Wirth, the majority floor leader said this:
“We have a behavioral health crisis. We have folks we see every day on the streets in our communities who need help. … The hope is to take one-time money and put it into that trust fund and then spin off a 5% annual return, more or less, basically taking one-time money and creating recurring money for behavioral health.”
Republican Senator Will Sharer, the minority floor leader, said this:
“For the first time in a decade, we’re at least trying to address the problem. … With each region, we’ll bring all of the various stakeholders together and say, okay, so here’s our problems. Here are the resources we have, here’s what we think we need, and here’s how we’re going to use those resources. So, the plan for San Juan County doesn’t have to look like Bernalillo County or anywhere else.”
Links to relied upon news sources are here:
https://www.abqjournal.com/news/article_4f1dc4ba-eb0a-11ef-ba1d-3779878c0568.html
BACKGROUND
A recent report by the New Mexico Justice Reinvestment Working Group found that 65% of individuals who enter the state’s criminal justice system have a behavioral health need and the criminal justice system cannot provide necessary medical treatment and facilities. According to Kaiser Family Foundation data, New Mexico has one of the nation’s highest suicide rates, and more than one-third of state residents reported anxiety or a depressive disorder in 2023,
Adrian Avila, the chief of staff for the Senate Finance Committee, was tasked with taking the lead on crafting the package after a special session called last summer by Gov. Michelle Lujan Grisham ended with the Democratic-controlled Legislature declining to take up all of the governor’s crime-focused agenda.
Avila went so far as to travel to Miami Florida last year with behavioral health advocates to tour the Miami-Dade County Court diversion program that has drawn accolades for its success. Avila said the “Miami model” would not be totally feasible in New Mexico because the state’s population is not as densely concentrated.
Avila described the package that grew out of countless meetings and negotiations as a “bottom-up” approach to tackling mental health and drug abuse issues across the state.
On February 4, Avila told the Senate Finance committee this:
“We’re creating an entire ecosystem here.”
Democrat Majority Floor Leader Peter Wirth of Santa Fe and Senate Minority Floor leader William Sharer of Farmington jointly sponsored Senate Bill 1 of the Behavioral Health Reform Package. On February 4 they presented their legislation together to the Senate Public Affairs Committee. Several other top Republicans and Democrats have teamed up to carry two bills. Republican Senator Sharer said this of the funding:
“Things are getting worse, not better. … This is a huge, huge amount of money, but also a huge accountability piece. … So this is it.”
JUDICIARY IN CHARGE OF NEW MENTAL HEALTH CARE MODEL
Under the passed legislation, a new mental health care model will put the state judiciary in charge of planning while leaving the state Health Care Authority largely in charge of overseeing funding. This is a significant change from the current system, which largely falls under the executive branch’s jurisdiction.
The legislation will increase accountability by requiring regional plans outlining priorities for providing mental health and substance abuse treatment. The new trust fund will provide annual funding to support the regional plans, which would largely be overseen by the state’s judiciary.
On February 4, Senator Wirth told the Senate Public Affairs Committee that it’s imperative the courts receive sufficient funding to carry out implementation of the region-based approach. Wirth said this:
“They’ve been willing to step up and we have to make darn sure they have the resources to do it.”
SENATE BILLS PASS DESPITE SKEPTICISM
Despite the bipartisan support, not all lawmakers were fully on board with the proposed package. Hobbs Republican Senator Larry Scott cast the lone “no” vote against the bill in the Senate Health and Public Affairs Committee and said he was concerned about accountability safeguards. Senator Scott said this:
“I remain skeptical that this approach is going to be successful because I don’t see a single responsible agency.”
Sen. Nicole Tobiassen said this:
“We know we have to have a solution for everyone. Is this the perfect solution? I don’t know that it is, but it appears that at least there’s some groundwork here that we can all work from.”
The Health Care Authority has also raised several issues with one of the bills in a legislative analysis, saying it could “fragment” oversight and funding authority for the state’s behavioral health system.
Some efforts to expand the state’s mental health treatment options are proceeding. On February 4, Clovis Mayor Mike Morris told the Senate Finance Committee that a group of eastern New Mexico cities and counties are set to move forward with building a new crisis triage center on an 18-acre site near the Plains Regional Medical Center. The facility would provide temporary beds for individuals dealing with mental illness or substance abuse issues to be housed before a treatment program could be determined. Mayor Morris said under the current system, most such individuals either end up in local hospital emergency rooms or in jails. Morris told the Senate Finance Committee this:
“That obviously is not as good as we think we can do.”
The link to relied upon or quoted news sources are here:
https://www.abqjournal.com/news/article_020e02b8-e324-11ef-9474-1fe32040c56c.html
GOVERNOR ON BOARD WITH PLAN AFTER FIRST EXPRESSING MISGIVINGS
Gov. Michelle Lujan Grisham at first expressed misgivings about the proposal of placing the judiciary in charge of overseeing regional plans for triage centers, mobile response teams and other behavioral health programs.
The Governor said this initially:
“To take an administrative arm of the courts and tell them to stand up behavioral health programs doesn’t make a lot of sense to me.”
Under the plan approved, the state judiciary would take on a larger role in approving regional behavioral health plans, while the state Health Care Authority would remain in charge of overseeing funding. This is a significant change from the current system, which largely falls under the executive branch’s jurisdiction.
Before the final Senate vote, the Governor’s Office indicated those concerns were largely resolved after negotiations with legislators and Supreme Court Chief Justice David Thomson.
JUDICIAL BRANCH PREPARED TO TAKE ON LARGER ROLE
Top judicial branch officials said New Mexico’s courts are willing to shoulder a larger role under a legislative plan to overhaul the state’s mental health and substance abuse treatment system. During the February 12 meeting of the Senate Finance Committee, Administrative Office of the Courts (AOC) Director Karl Reifsteck acknowledged the judicial branch is not currently a key player in the state’s behavioral health system. Reifsteck said the court system is willing to take on a larger role and has already begun preliminary work on how it would implement the changes proposed by a legislative package of bills. Reifsteck said this:
“This is not a role the courts requested, but it’s one we’re happy to accept if that’s the Legislature’s decision”.
Reifsteck said the judicial branch would act “very, very quickly” to implement the bill once passed by lawmakers and signed into law by the governor.
During the 2024 Special Session, legislators appropriated $3 million to ramp up court-ordered assisted outpatient treatment programs for individuals with mental illness in three judicial districts. The 3 behavioral health Senate bills moving forward would put the judiciary in charge of planning while leaving the state Health Care Authority largely in charge of overseeing funding.
During the February 12 meeting of the Senate Finance Committee, Chief of Staff Adrian Avila of the committee said early positive returns on those investments played a role in the decision to task the courts with a broader, permanent role in overseeing behavioral health programs.
During the February 12 Senate Finance committee meeting Health Care Authority Secretary Kari Armijo described the proposal to have the court’s administer the program as having a “bifurcated” accountability structure but she did not express opposition to the plan.
Senate Finance Committee Chairman George Muñoz, D-Gallup, said this about the legislation:
“We all see this as a crisis. [The current system] is not working.”
NEW MEXICO SUPREME COURT ALSO SEEKS FUNDING FOR BEHAVIORAL HEALTH
On January 23, New Mexico Supreme Court Chief Justice David Thomson addressed New Mexico lawmakers to discuss the financial needs of the state’s court system. Thomson highlighted several areas requiring funding. One area he expressed concern over was new efforts and court outpatient treatment programs for individuals with mental illness.
During his State of the Judiciary Address Supreme Court Chief Justice David Thomson said this:
“The judiciary is committed to doing the hard work to support the policy initiatives of the Legislature and the executive on behavioral health. … We will do our part. … My request to you is that we are not asked to do more to the detriment of our core judicial function.”
Thomson asked lawmakers to make the $3 million in funding approved during a special session last year recurring to ramp up court-ordered assisted outpatient treatment programs for individuals with mental illness in three judicial districts. Judge Thomson said this:
“We need that extended if this is a program that is of value to you so we can be consistent in its application.”
Behavioral health remains a priority for the court’s with the $3 million pilot program underway for Assisted Outpatient Treatment (AOT). While early results show some success, comprehensive outcomes are yet to be determined. Thomson stressed funding not only courts but also criminal justice partners like law enforcement and public defenders.
A treatment program in the Santa Fe-based 1st Judicial District was recently launched using Legislature’s initial start-up funding, though Thomson said he did not yet have information about the number of participants. Judge Thomson told law makers “We literally turned on the switch”.
Senate Majority Leader Peter Wirth told judicial officials during a Senate Committee hearing he’s committed to securing recurring funding for the assisted outpatient program, which connects defendants with counseling, medication and other services for up to one year. Wirth also said it’s important for such court programs to be in place and fully staffed as legislators consider changes to the state’s approach to assisting individuals found not to be competent, both in criminal and civil cases. Wirth referring to the state’s assisted outpatient treatment programs said this:
“This law has been on our books since 2016 and we just weren’t using it.”
CRIMINAL COMPETENCY BILL PASSES AS PART OF OMNIBUS CRIME PACKAGE
House Bill 4 is the criminal competency legislation. On February 22, the New Mexico legislature gave final approval and enacted 6 crime bills in House Bill 8 which is the Omnibus Crime Package. House Bill 4 passed as part of the House Bill 8 Omnibus Crime Package. House Bill 4 is the criminal competency legislation and it specifically requires that competency evaluators determine whether defendants are dangerous to themselves or others. After a competency hearing, and if a defendant is found not to be competent, a judge would then decide whether the defendant poses a threat. Based on that determination, a defendant would either be ordered to attend an assisted outpatient treatment program or be sent to the state Behavioral Health Institute in Las Vegas, New Mexico.
House Bill 4 gives prosecutors more options to involuntarily commit people into a locked psychiatric facility if they are found to be dangerous to themselves or others and unable to stand trial.
Under House Bill 4, when a court determines that a defendant is not competent to proceed in a criminal case the court shall determine if the defendant is dangerous. A defendant who is not competent is dangerous if the court finds by clear and convincing evidence that the defendant presents a serious threat of:
(1) inflicting great bodily harm, as defined in Section 30-1-12 NMSA 1978, on another person;
(2) committing criminal sexual penetration, as provided in Section 30-9-11 NMSA 1978;
(3) committing criminal sexual contact of a minor, as provided in Section 30-9-13 NMSA 1978; (4) committing abuse of a child, as provided in Subsection D of Section 30-6-1 NMSA 1978;
(5) violating a provision of the Sexual Exploitation of Children Act;
(6) committing human trafficking, as provided in Section 30-52-1 NMSA 1978;
(7) committing a felony involving the use of a firearm; or
(8) committing aggravated arson, as provided in Section 30-17-6 NMSA 1978.
The link to review House Bill 4 is here:
https://legiscan.com/NM/text/HB4/2025
Sen. Peter Wirth, majority floor leader, said this about House Bill 4:
“I think the governor’s focus really in the special session was on this competency bill, and it took everything we had during an interim process, 30 days’ worth of hearings, to have that be the centerpiece of the public safety package this year.”
Links to quoted or relied upon news coverage is here:
https://www.abqjournal.com/news/article_aa158e90-d9c9-11ef-aa34-477662558954.html
GUTTING OF NON-PROFIT MENTAL HEALTH CARE PROGRAMS BY REPUBLICAN GOVERNOR SUSANA MARTINEZ
The cruelest thing that Governor Susana Martinez did as Governor was order a politically motivated and bogus “audit” of mental health services by nonprofits in New Mexico which devastated New Mexico’s behavioral health care system. More than 160,000 New Mexicans received behavioral health services in 2014, with most of those services funded by Medicaid, according to the Human Services Department.
In June 2013, under the direction of Governor Martinez, the Human Services Department cut off Medicaid funding to 15 behavioral health nonprofits operating in New Mexico. The Martinez Administration said that the outside audit showed more than $36 million in overbilling, as well as mismanagement and possible fraud. In early 2016, at least 13 of the 15 nonprofits that were shut down. The Martinez Human Services Department agency then brought in the 5 Arizona providers of their choosing to take over. Attorney General Hector Balderas did an investigation and found no fraud and cleared the nonprofits of fraud.
Even though New Mexico Attorney General Hector Balderas exonerated the behavioral health nonprofits the damage had been done to the New Mexico nonprofits and many simply went out of business. Three of the five Arizona providers brought in by Governor Susana Martinez’s administration in 2013 to replace the New Mexico nonprofits pulled up stakes in the state and the states mental health system never fully recovered.
https://www.abqjournal.com/749923/third-arizona-behavioral-health-provider-to-pull-out-of-state.html
COMMENTARY AND ANALYSIS
The final passage of the Behavioral Health Reform Package by the New Mexico Legislature with a bi-partisan vote is a major victory and a reflection of just how far the state has come to fix its broken health care system. The passage of the 3 bills comes more than 12 years after former Republican Governor Susana Martinez gutted New Mexico’s behavioral system in 2013, freezing Medicaid funding to 15 providers over fraud and overbilling accusations. All the accused providers were later exonerated by Attorney General Hector Balderas of wrong doing, but the damage had been done and many mental health care providers simply went out of business and closed. The state has tried to play catch up, better never filled the void.
Final enactment by the legislature of all 3 Senate bills making sweeping changes to the state’s health care system to deal with mental illness and drug abuse is long overdue and there is indeed cause for celebration. The Behavioral Health Reform Package addresses programs and facilities. The huge void to address the mandatory civil commitment of those who are to be danger to themselves and others and criminal competency was filled with the enactment of House Bill 4 as part of House Bill 8 known as the Omnibus Crime Package.
House Bill 4 specifically require that competency evaluators determine whether defendants are dangerous to themselves or others. House Bill 4 essentially contains the very same provisions that were mandated in Senate Bill 16 that was rejected last year during the special session. Under House Bill 4, after a civil competency hearing, and if a defendant is found not to be competent, a judge would then decide whether the defendant poses a threat. Once a person is determined not to be competent and determined to be a threat to themselves and others, the court could order mandatory treatment. With the passage of the Behavioral Health Reform Package, there will be treatment facilities and mental health care that will be provided under the direction of the courts.