BOX 5-1New Mexico's Behavioral Health Collaborative: A Case Study in Policy Coordination

In 2003 the Governor of New Mexico identified as a major policy issue the fact that New Mexico's behavioral health system (like others across the United States) reflected the problems cited in the report of the President's New Freedom Commission: insufficient and inappropriate services, uneven access and quality, failure to maximize resources across funding streams, duplication of effort, higher administrative costs for providers, and overall fragmentation that makes service systems difficult to access and manage effectively. After consultation with key cabinet secretaries, the governor announced a new approach to address these problems through the creation of a high-level policy collaborative. This executive-level body was charged specifically with achieving better access, better services, and better value for taxpayer dollars in mental and substance-use health care.

This group, consisting of 17 members including the heads of 15 agencies, was established in law by the New Mexico legislature effective May 2004 and charged with creating a single behavioral health (mental and substance-use treatment) delivery system across multiple state agencies and funding sources. The vision that guided this effort, based on months of public participation, was that this single system must support recovery and resiliency so that consumers can participate fully in the life of their communities. The agencies forming the collaborative reflected these broad goals and included those responsible for such areas as housing, corrections, labor, and education, as well as primary health and human services agencies.

To ensure that this broad perspective would be reflected in the collaborative's actions, the group decided that decisions would be made whenever feasible by consensus, but that if votes were required, each agency would have a single vote regardless of its budget or size. The group is cochaired by the secretary of Human Services and (in alternating years) the secretary of Children, Youth, and Families or the secretary of Health. Such a broad policy vision clearly also required that the collaborative develop coordinated structures for the efficient management of a broad range of funds and services. Therefore, a request for proposals was issued, and a contractor was selected as the single statewide entity to manage approximately $350,000,000 in cross-agency funds for the first phase of the change process. In addition, the collaborative has formed senior-level coordination teams, including one focused specifically on cross-cutting policy issues. A single Behavioral Health Planning Council has also been established to form an ongoing partnership with consumers, families, providers, and state agencies in keeping the system on track. In addition, local collaboratives are being formed with cross-agency state assistance across all of the state's 13 judicial districts, as well as in its Native American communities, to ensure strong feedback and coordination involving stakeholders at the local level as a guide for collaborative state policies and actions. The overall transformation also is being carefully evaluated by multiple groups to help guide future work of this broad policy nature.

SOURCE: Personal communication, Leslie Tremaine, Behavioral Health Coordinator, New Mexico BH Collaborative, on July 28, 2005.

From: 5, Coordinating Care for Better Mental, Substance-Use, and General Health

Cover of Improving the Quality of Health Care for Mental and Substance-Use Conditions
Improving the Quality of Health Care for Mental and Substance-Use Conditions: Quality Chasm Series.
Institute of Medicine (US) Committee on Crossing the Quality Chasm: Adaptation to Mental Health and Addictive Disorders.
Washington (DC): National Academies Press (US); 2006.
Copyright © 2006, National Academy of Sciences.

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