Last week we interviewed Susie Galea, the BHMC State Coordinator in New Mexico, to discuss the project’s current work. This week we had a chance to look a little closer at some of the challenges facing BHMC in New Mexico and ask Susie a few questions about how the program proposed to overcome those challenges.
What is the Goal of BHMC in New Mexico?
The #1 goal of the Building Healthy Military Communities program is Total Force Fitness. What Mission Readiness looks like for each branch of the military may vary, but the readiness and resiliency requirements of reserve component members is the same of the active duty status component, regardless of unmatched resources. Where there is a gap between requirements and resources is there is an opportunity to build upon community capacity. A healthy local community reflects a healthy military of all branches and status, and that’s why the Building Healthy Military Communities program is not just going to benefit the service members, veterans, and their families in New Mexico, but this program will benefit all of NM through the “all boats rise” theory.
There’s no other program, like Building Healthy Military Communities, and it is fitting that it is in New Mexico (only 1 of 7 states participating). The new program is here to highlight the local achievements and best practices throughout New Mexico, share ideas statewide, recognize the needs of all branches and status’ of military members, veterans, and their family members, and coordinate mutual efforts while eliminating redundancies.
Can you talk about how BHMC is connecting local resources and working to build community capacity?
Partnering with community resources, like the Extension Services through NMSU, we can address gaps of services and community needs within every single county statewide. Whether most are aware or not, there are service members living in their community, and if they are like half of the NM Guardsmen who have not yet deployed on federal mission for at least 145 days, those 2000+ service members do not have federal/VA benefits, and rely on local resources for overall health. Amongst the 4 military installations in NM, there are also 15 Readiness Centers spread throughout the state. Extension Services that are partners to BHMC domains:
- Family Health and Wellness (Cooking Classes and Fitness Training)
- Financial Health (Personal Finance and Other Family Resource Management)
- Economic Development (Veteran’s establishing or renewing farm lands)
Working together, through a New Mexico Military Community Covenant, we New Mexicans will find the utility of partnerships that connect us at all levels of governments that didn’t seem possible before. Together, we can remove barriers of health and welfare that we need to advance our families and economy into a future we share, while maintaining our culture. Through the Building Healthy Military Communities program, which will expound upon our wonderful resources, we all will increasingly find our capacity to thrive with more ease for everyone in New Mexico.
What are the first steps BHMC will take to create Total Force Fitness in New Mexico?
My BHMC goal is to stand-up regional Inter-Service Family Assistance Committees (ISFACs) as soon as possible to create a sustainable statewide Joining Community Forces (JCF) that has great impacts for both identifying resources for NM Service Members, Veterans, and Families, and a great statewide team impact toward 2018 legislation that will strategically address our 8 domains of Building Healthy Military Communities for New Mexico’s present and future.
I cannot do any of this without our formal partners – All New Mexico military leaders, civic leaders, community partners, and programs such as:
Strong Bonds, NM Dept. of Veteran Affairs, Uniformed Services Blended Retirement System, Vets4Warriors, Tricare, Guard Your Health, Safe Helpline, Military OneSource, Ready Airman, Local NM Veteran Civic Groups, Indian Health Services, Community Action and Information Boards, AmeriCorps, all county Extension Services, and more.
What is the #1 challenge facing BHMC in New Mexico?
The main challenge for New Mexico is geographic dispersion. If you look at the map below, and the key, you can see that the majority of installations are not located within a convenient proximity to a Readiness Center.
Can you talk more about the needs of the geographically dispersed population and how BHMC plans to address them?
1. The number one need and gap in services for NM Service Members, Veterans, and Families is Emergency Financial Assistance. Here’s our plan to address this issue:
A. Establish a NM Military Family Foundation (501c3) under the state of NM.
- Example of best practice: MN’s foundation raises $300k/yr, and is able to provide a one-time grant request for emergency financial needs (medical, housing and vehicle repair).
B. Identify affordable child care that is licensed and accessible
- Expand qualifiers and budget for the Child Care Fee Assistance program through CYFD. It has been an issue of Readiness and public safety when NM Guard/Reserve are unable to attend their one weekend/month training due to child care cost/availability.
C. Unemployment and under employment of NM Guard/Reserve, Veterans, and their Families continues to be addressed by a myriad of BHMC partners.
- Without NM’s focus on community health, we cannot legislate ourselves enough new or expanded jobs in the state. Our workforce health, since the recession and decline in behavioral health care providers, has not been attractive to Fortune 500 companies. The $20M/yr state legislative economic incentives for new and growing businesses has not proven enough to override the need for reinvestment in workforce development.
2. Access to behavioral health care providers is more than a statewide crisis, but is even more difficult for military members that utilize the Tricare medical insurance.
A. The state of NM has reduced Medicaid medical provider payments for care. Those providers, without a diversity of clientele of a variety of insurances, leave NM to become providers in neighboring states.
- New Mexico and the ACA’s Medicaid expansion – Medicaid enrollment up 66 percent since 2013.
- Children make up 64.5 percent of New Mexico’s Medicaid population.
- As of 2014, 50% of NM population was either on Medicaid or Medicare.
B. Tricare’s most recent contracted payer to medical providers, United Health Care, took up to 90 days to send provider payments for care. Which is not a sustainable medical business model.
- A majority of medical providers, that accepted Tricare 5 years ago, are no longer accepting the insurance that all active duty and some reserve component members use to access care.
* BHMC is documenting the access to care challenge to provide supporting data for both increased State of NM payment ratio reimbursements for medical provider payments, and an improved Tricare payer contracting model for future payer contracts of Tricare beneficiaries.
3. Increased opioid and illicit drug use and addictions is more than a statewide crisis. Random military member drug screenings reveal the growing self-medicating drug environments, where NM service members reside, is reflected.
A. Treatment from Opioid Abuse cost NM $92 per-capita, as of 2015.
B. Direct correlation between NM opioid abuse and the behavioral health care provider shortages.
- We need more local support for New Mexico medical providers who medically treat opioid addiction
- We need state legislative support to actually fund the Governor’s Behavioral Health Initiative from 2016.
- The public health community can continue to collaborate on SAMHSA federal grant funding to increase both behavioral health providers and substance abuse treatment providers.
C. The New Mexico labor force, of those abusing substances, creates a shallow pool of labor for existing and incoming businesses.
- NM has the highest unemployment rate in the nation (2017).
4. Increased public safety concerns and statistics of rising violent crime rate, and of non-violent thefts and vandalism.
A. Increased statewide crime rates are directly related to the increase in substance abuse and drug addictions.
- The behavioral health care provider shortage is a crisis.
- Address public education, behavioral health care, and substance abuse treatment gaps in services with state and local legislation and funding.
B. Not enough public safety officers to recruit and maintain to meet the rising calls for public safety help.
- NM state retirement (PERA) legislation change and increased funding would allow trained and retired officers to maintain or regain their public safety officer positions while collecting their retirement pay.
- In the current NM environment of increased misdemeanor crimes and substance abuse, qualifying new public safety officers is the challenge. Our shared requirements and resources identify gaps in services to recruit new public safety officers as quickly as needed.
C. Economic concern for local businesses, potential new businesses, and individual families throughout NM.
- Victims of crime often are financially hurt.
5. Employment: Will more jobs and new companies come to New Mexico before we address our gaps in services, and current public health and workforce environments?
A. NM has the highest unemployment rate in the nation. Are all those currently unemployed eligible for employment having no misdemeanors or substance abuse problems, and have obtained above high school education?
B. We need more jobs, of a variety of technical fields, to come to NM where we have a competitive workforce.
What do you need from the communities of New Mexico?
Are you, as a New Mexican or want-to-be-New-Mexican, tired of hearing these statistics: NM has the highest unemployment rate in the nation, NM is short of behavioral health care providers, parts of NM have the highest rates of opioid abuse and over doses, NM has one of highest DWI rates and deaths, NM’s population growth represents an ‘Exodus’ to surrounding states, NM public education ranks 3rd to last in the nation, NM ranks last in child welfare, NM has the highest senior hunger rate, NM’s metropolitan non-violent crime rate has almost doubled in recent years with statewide police officer shortages, and NM’s state budget (our tax dollars) cannot afford the needed maintenance of our public schools and road infrastructure?
To truly make this new program and resource beneficial to all New Mexicans, I need your help – New Mexico. I need your ideas, I need more knowledge of the resources you find best beneficial, and I especially need your criticism. That’s right, no idea is a bad idea, there is no door I’m afraid to knock on, and I know that conflict is sometimes needed to produce mutually desired progress.