NMDOH FY18 QUARTER 4 STRATEGIC PLAN PROGRESS REPORT

Why Is This Important?

What We Do

The Public Health Division (PHD) fulfills the NMDOH mission by working with individuals, families, communities and partners to improve health, eliminate disparities, respond to health threats, and ensure timely access to quality, culturally competent health care.

Who We Serve

The Public Health Division serves all New Mexicans.   

How We Impact

PHD staff members implement evidence based public health interventions and promote healthy lifestyle choices that reduce the burden of chronic and infectious disease in our communities. Public Health assures access to health care through case management, and through recruitment and retention efforts including the J-1 Visa Program, licensing of midwives and community health workers, tax credits for  rural health providers, and collaboration with rural primary health care providers throughout the state.

Budget

FY18 OPERATING BUDGET: $ 181,331,100

• General Funds: $ 49,846,500
• Other Transfers: $ 16,839,500
• Federal Funds: $ 72,078,100
• Other State Funds: $ 42,567,000

Accomplishments

During the fourth quarter of FY18, some of PHD’s accomplishments included:

The Southwest Region was able to conduct a Functional Exercise called “Operation Cascarones” that simulated a 3-day acute infectious disease outbreak affecting the local population along the US border with Mexico, within the Paso del Norte Region (El Paso, TX, Ciudad Juarez, Chihuahua, MX, and Las Cruces, NM). Common cases with international demographics are communicated to and through binational public health organizations and agencies. Simulated social media interaction between the public and exercise participants addressed health concerns of the community and exercised public information and warning. The Southwest Region took the lead on this exercise with collaborations from Office of Border Health, Texas Department of Health, and Health partners from Chihuahua Health Services.

The Northeast Region piloted telemedicine/telehealth amidst a regional clinician shortage to bring access to family planning services in rural communities in Northeast New Mexico. Over the past year, the Region collaborated with the Family Planning Program to pilot the use of technology to bring telehealth services to Guadalupe County. Due to the success of this pilot, staff were able to expand this opportunity to Colfax County, with future hope of adding a third, Union County, in FY19.  

The Tuberculosis (TB) Program coordinates the TB ECHO clinic for active TB patients, started and supports the Navajo Nation ECHO clinic for Navajo patients treated in New Mexico or Arizona, and is actively involved in the first binational bilingual TB ECHO for US, Mexico, and Central American patients.  All three train health workers in TB management while providing high quality care for patients.

With funds from the Brindle Foundation, NMDOH purchased ad space through National CineMedia to increase awareness of effective birth control methods and clinic locations. The mobile banner and Facebook ads directed females aged 13-17 and 18-19 to websites with information on birth control choices.  Another campaign beginning in November, 2018 will include ads for birth control awareness and the BrdsNBz text messaging service and a video for birth control awareness. 

What We Do

The Epidemiology and Response Division (ERD) monitors health, provides health information, prevents disease and injury, promotes health and healthy behaviors, responds to public health events, prepares for health emergencies, and provides emergency medical, trauma, vital registration, and sexual assault-related services to New Mexicans.

Who We Serve

ERD serves all New Mexicans, particularly those at risk for injury, disease, and health emergencies, and those in need of emergency medical services, trauma care, birth certificates, and death certificates.

How We Impact

ERD provides services through six bureaus: Vital Records and Health Statistics (VRHS), Health Emergency Management (BHEM), Emergency Medical Systems (EMS), Environmental Health Epidemiology (EHEB), Infectious Disease Epidemiology (IDEB), and Injury and Behavioral Epidemiology (IBEB). In addition, the Community Health Assessment Program (CHAP) operates the online NM Indicator-Based Information System (IBIS) providing data on numerous health-related measures; and the Health Systems Epidemiology Program (HSEP) analyzes and disseminates hospitalization and emergency department data.

VRHS annually registers approximately 26,000 births and 17,000 deaths, and issues over 250,000 birth and death certificates. VRHS also analyzes and distributes data to numerous agencies and organizations to assist them in improving the health of New Mexicans. By working at the state, regional, and local levels through public and private partnerships BHEM enables New Mexicans to prevent, detect, report, respond to, and recover from health-related emergency and disaster incidents. The EMS Bureau administers the Emergency Medical Services (EMS), Trauma, and Stroke/STEMI (Heart Attack) programs. EMS assures licensure for over 8,000 NM Emergency Medical Technicians (EMTs).

EHEB conducts surveillance on conditions associated with environmental exposures (e.g. drinking water, air, and soil), provides information to other programs and the public, and implements interventions. IDEB performs surveillance for notifiable infectious diseases and conducts epidemiologic field investigations associated with those diseases, investigating over 10,000 potential cases each year. IDEB and EHEB also provide an on call service, responding to over 5,000 calls annually from healthcare providers, state agencies, educational facilities, the general public, and others seeking advice and recommendations. IBEB analyzes alcohol- and drug-related public health problems; supports substance abuse prevention programs and policy initiatives; provides injury prevention services for infants, children, adolescents, adults, and the elderly; and conducts studies in injury epidemiology. IBEB also conducts the Behavioral Risk Factor Surveillance System annual survey of about 9,000 adults as well as the Youth Risk and Resiliency Survey of about 30,000 mid- and high school students to provide state, county, and school district level data on risk behaviors and resiliency factors.

Budget

FY18 OPERATING BUDGET: $28,188,700

• General Funds: $12,002,700
• Other Transfers: $766,200
• Federal Funds: $15,012,100
• Other State Funds: $407,700

Accomplishments

• The older adult falls death rate decreased 12 percent in 2016 to 91.6 deaths/100,000 at the same time the number of health care providers and older adults trained in evidence based fall prevention approaches has increased substantially.
• New Mexico's drug overdose death rate dropped from 8th highest to 12th in 2016.
• Using federal funding for Zika prevention and detection, birth defects surveillance has been made much more comprehensive with increased services to families with birth defects.
• A new trauma center, the first in Doña Ana County, was designated.
• With an early start to the influenza season, 10 outbreaks in long term care centers were investigated and, as a result, recommendations for control were provided.
• Crisis standards of care are being developed to increase the number of tools available to be used in a major public health emergency.
• Emergency department syndromic surveillance uses are expanding to tracking non-fatal overdose, suicide attempts, and influenza.
• Program evaluation capacity is being enhanced largely through federal funding.
• The number and percentage of retail pharmacies that dispense naloxone has increased substantially to 236 (61%).

What We Do

The Scientific Laboratory Division (SLD) provides laboratory analysis and scientific expertise for public health policy development, environment, and toxicology programs in New Mexico (NM). SLD provides timely identification in order to prevent, identify, and respond to threats to public health and safety from emerging and unusual infectious diseases in humans, animals, water, food, and dairy, as well as chemical and radiological hazards in drinking water systems and environmental water, air, and soil. In addition, the laboratory performs drug testing and provides expert witness testimony for forensic investigations of Driving While Intoxicated/Driving While Under the Influence of Drugs (DWI/DUID) and cause of death from drugs and infectious disease. SLD is the primacy bioterrorism and chemical terrorism response laboratory for the state and provides training for clinical laboratories throughout New Mexico. 

Who We Serve

New Mexico statute dictates that the Scientific Laboratory Division is the primacy laboratory for the NMDOH, the New Mexico Environment Department, and the New Mexico Department of Agriculture, as well as the testing and regulatory authority for impaired driving testing.

How We Impact

The Scientific Laboratory is New Mexico’s official public health, environmental monitoring, and forensic toxicology laboratory. In the above roles, the Scientific Laboratory Division operates the following programs:

• Infectious disease reference testing laboratory for the New Mexico Department of Health, NM hospitals, and clinical labs;
• Primacy NM regulatory drinking water testing laboratory for the Environmental Protection Agency (EPA) and NM Environment Department;
• Regulatory air testing laboratory for NM Environment Department and City of Albuquerque;
• Primacy NM regulatory dairy testing laboratory for the Food and Drug Administration and NM Department of Agriculture;
• Veterinary infectious disease reference testing laboratory for the NM Department of Agriculture’s Veterinary Diagnostic Services;
• Food borne infectious disease testing laboratory;
• Certification inspectors for private dairy and dairy testing laboratories for the NM Environment Department and the NM Department of Agriculture;
• DWI/DUID alcohol and drug testing laboratory;
• State toxicology expert witnesses for DWI/DUID criminal cases;
• Certifying authority for NM law enforcement officers for breath alcohol testing;
• Bio- and chemical terrorism response laboratory for New Mexico;
• Disease and drug testing laboratory for the NM Office of the Medical Examiner.

Budget

FY18 OPERATING BUDGET: $ 12,904,200

• General Funds:      $7,599,600
• Other Transfers:    $1,251,100
• Federal Funds:       $2,646,000
• Other State Funds: $1,407,500

Accomplishments

During the fourth quarter of FY18, some of SLD’s accomplishments included:

• The Chemistry Bureau:
  • Was certified by the Environmental Protection Agency to perform Method 200.8 for the detection of Mercury.  Using this method allows results to be reported more rapidly than the current method (245.1).
  • Was among only a few public health laboratories in the nation that were EPA approved to perform chemical testing under the Fourth Unregulated Contaminant Monitoring Rule (UCMR4).
• The Toxicology Bureau has reached out to state partners such as the Attorney General's Office, special prosecutors, and the state's Drug Recognition Expert coordinator to strengthen relationships with the laboratory in combating DWI in New Mexico.
• The Biological Sciences Bureau:
  • Assisted the NMDOH Epidemiology and Response Division with a Legionella investigation involving an elderly care facility.
  • Identified a rarely encountered Corynebacterium diphtheriae isolate, which was confirmed by the Centers for Disease Control and Prevention.
  • Completed verification of new hepatitis B surface antibody assay on the Architect i1000 instrument. 
  • Prepared and presented a poster at the 2018 Association of Public Health Laboratories annual meeting describing rabies testing.

What We Do

The Facilities Management Division (FMD) fulfills the NMDOH mission by providing:

• Programs in mental health, substance abuse, long-term care, and physical rehabilitation in both facility and community-based settings;
• Safety net services throughout New Mexico.

Who We Serve

FMD oversees five healthcare facilities and one community program. Most individuals served by NMDOH facilities have either complex medical conditions or psychiatric disorders that manifest in violent behaviors, and private sector providers are either unable or unwilling to serve these complex individuals, many of whom are restricted to NMDOH facilities by court order.

How We Impact

FMD Facility staff cares for both New Mexico adult and adolescent residents, who need continuous care 24 hours-a-day, 365 days-a year as well as provision of a variety of behavioral health outpatient services.

Budget

FY18 OPERATING BUDGET: $124,072,300

• General Funds: $58,125,800
• Other Transfers: $1,118,200
• Federal Funds: $3,992,400
• Other State Funds: $60,835,900

Accomplishments

During the 4th quarter of FY18, some of FMD's accomplishments included:

• Turquoise Lodge Hospital:
  • Improved Intensive Outpatient Programming to enhance family involvement.
  • Created a new user friendly treatment plan for Inpatient and Outpatient services.
• New Mexico Behavioral Health Institute:
  • Conducted patient surveys which resulted in over 95% satisfaction; target is 90%.
  • Held patient social activities such as a Cinco de Mayo activity at the Farm (dancing, fishing, volleyball, horseshoes, nature walk, basketball and music), an Easter celebration with egg hunt, and a Mother's Day celebration.
  • Completed ligature project at the Adult Psychiatric Division.
  • United World College students continued voluntary participation in Long Term Care resident activities.
  • Held staff trainings on Bipolar Disorders, Suicide Assessment and Intervention, Chronic Anxiety, and Mental Health First Aid.
• Sequoyah Adolescent Treatment Center:
  • Completed the landscaping courtyard project; sod placed, sprinkler system repaired, and drainage system renovated.
  • Hosted a staff and resident talent show.
  • The New Mexico Public Education Department hosted a spelling bee for the residents.
• New Mexico Rehabilitation Center:
  • Built stronger working relationships with the local healthcare community and referral bases to further sustain and improve census and continuum of care.
  • Increased patient safety satisfaction scores; results were 94%+ in Chemical Dependency and Medical Rehabilitation Units.
  • Passed accreditation and federal regulatory standards to sustain program and quality of care.
• Fort Bayard Medical Center:
  • Conducted family surveys which resulted in 90%+ satisfaction in Quality of Life and Quality of Service.
  • Held staff trainings on Clinical Competencies, Customer Service, and annual Centers for Medicare and Medicaid Services requirements.
• Los Lunas Community Program:
  • All Finance, Quality, Clinical, and Nursing staff successfully moved to the Los Lunas Community Program Campus from a privately leased building.
  • Completed the campus utility metering project to allow for separate tenant billing.
  • Completed fire panel retrofits in four campus buildings.
  • Conducted audit, which resulted in full compliance with all conditions of Immediate Care Facility for Individuals with Intellectual Disabilities services.

What We Do

Who We Serve

DDSD is the primary state agency that funds community services and supports for people with disabilities and their families in New Mexico.

How We Impact

DDSD's primary focus is on assisting individuals with developmental disabilities and their families in exercising their right to make choices, grow and contribute to their community.

Budget

FY18 OPERATING BUDGET: $159,443,800

• General Funds: $146,264,200
• Other Transfers: $8,760,400
• Federal Funds: $2,819,200
• Other State Funds: $1,600,000

Accomplishments

In FY18 Q4, some of DDSD's accomplishments included:

• Community Programs Bureau:
  • Community Programs Bureau representatives presented at the New Mexico Developmental Disabilities Planning Council (DDPC) 2018 Statewide Summit on Advocacy and the Parents Reaching Out Annual New Mexico Family Leadership Conference on the revised Developmental Disabilities Waiver Service Standards.
  • The Rate Study Evaluation Committee reviewed proposals and selected a vendor to complete the 2018-2019 comprehensive rate study for the Developmental Disabilities, Mi Via, and Medically Fragile Waivers.
  • Mi Via Unit is fully staffed with three new Mi Via Coordinators and a new Mi Via Program Manager.
  • The public comment period for the Mi Via proposed rule change closed June 29th.
  • Newly designed Mi Via website completed, will be in opertion effective July 2018.
• Intake & Eligibility Bureau:
  • The Central Registry Unit conducted seven allocation fairs in preparation for the FY19 allocation group of 80 individuals. Of those individuals, 39% have selected the Mi Via Waiver and 61% have selected traditional DD Waiver. By the end of the quarter, 35% of the individuals completed medical and financial eligibility through HSD.
  • The unit also processed 419 new registrations for waiver services and determined 156 applications matched the definition of development disability, thus adding them to the waiting list. Three hundred thirty-nine applications were closed due to not matching the developmentally disabled definition or for not completing the application process.
• The Pre-Admission Screen and Resident Review (PASRR) Unit received and processed 367 Level I Identification Screens, which allows for individuals with intellectual disability, mental illness, or a related condition to be appropriately admitted to Medicaid Certified Nursing Facilities.

What We Do

The Division of Health Improvement (DHI) plays a critical role on improving the health outcomes and ensuring the safety of New Mexicans. DHI ensures that healthcare facilities, community based Medicaid waiver providers and community support services deliver safe and effective healthcare and community services in accordance with laws, regulations, and standards of practice.

Who We Serve

DHI works closely with key stakeholders to promote and protect the health, safety, and quality of life of New Mexicans. Our stakeholders include executive and legislative policy makers; providers; facilities and contractors; other state, local, and federal government agencies; advocacy groups; professional organizations; provider associations; various task forces and commissions; and the tax paying public at large.

How We Impact

Key DHI enforcement activities include: conducting various health and safety surveys for both facilities and community-based programs; conducting investigations of alleged abuse, neglect, exploitation, death or environmental hazards; and processing over 44,000 caregiver criminal history screenings annually.

Budget

FY18 OPERATING BUDGET: $12,047,500

• General Funds: $4,192,600
• Other Transfers: $3,348,400
• Federal Funds: $2,613,000
• Other State Funds: $1,893,500

Accomplishments

During the fourth quarter of FY18, some of DHI’s accomplishments included:

• The caregiver criminal history screening program processed 10,249 background checks during the fourth quarter. The average number of days to complete a background check was one day.

Health Facility Licensing and Certification:

• Established the new Minimum Data Set (MDS)/Outcome and Assessment Information Set (OASIS) coordinator roles with Long-Term Care (LTC) and Home Health Agency providers and their respective professional associations, as well as the Quality Improvement Organization (QIO).
• Provided updated resources and training to LTC providers and surveyors.
• Collaborated with Oklahoma, Texas, and Louisiana in Centers for Medicare and Medicaid Services (CMS) regional meeting.
• Hired a full time Clinical Laboratory Improvement Amendments (CLIA) surveyor.
• Currently on target for completing federal Mission Priority Document (MPD) requirements for CMS.
• Began tracking complaints of Abuse, Neglect, and Exploitation in health facilities in the Aspen Complaints Tracking System (ACTS).
• Completed all End Stage Renal Disease initial certifications.

  Community Based Waiver Programs:

• Fully staffed the Individual Qualty Review (IQR) survey team.
• The Quality Management Bureau (QMB) trained surveyors and implemented the new survey tools for the new 2018 version of the Developmental Disabilitiies Waiver Standards.
• QMB conducted provider training in four regions to-date at the Developemental Disabilities Supports Division regional meetings on the new survey scoring and changes to the tools.

What We Do

The Medical Cannabis Program (MCP) was created in 2007 under the Lynn and Erin Compassionate Use Act (the Act). The purpose of this Act is to allow the beneficial use of medical cannabis in a regulated system for alleviating symptoms caused by debilitating medical conditions. New Mexicans with a diagnosed qualifying medical condition are eligible to participate in the Program.

Who We Serve

The Program serves New Mexicans with qualifying medical conditions diagnosed by a health care provider. There are currently 21 qualifying medical conditions:

• Amyotrophic Lateral Sclerosis (ALS)
• Cancer
• Crohn’s Disease
• Epilepsy/Seizure Disorder
• Glaucoma
• Hepatitis C Infection currently receiving antiviral treatment (proof of current anti-viral treatment required)
• HIV/AIDS
• Huntington’s Disease
• Hospice Care
• Inclusion Body Myositis
• Intractable Nausea/Vomiting
• Inflammatory autoimmune-mediated arthritis
• Multiple Sclerosis
• Damage to the nervous tissue of the spinal cord, with (proof of objective neurological indication of intractable spasticity required)
• Painful Peripheral Neuropathy
• Parkinson’s disease
• Post-Traumatic Stress Disorder
• Severe Chronic Pain
• Severe Anorexia/Cachexia
• Spasmodic Torticollis (Cervical Dystonia)
• Ulcerative Colitis

How We Impact

The Program enables the provision of compassionate care for people that have certain illnesses who prefer to use cannabis to alleviate symptoms related to their diagnosis.

Budget

FY18 OPERATING BUDGET: $2,750,000

• Other State Funds: $2,750,000

Accomplishments

During the fourth quarter of FY 18, some of MCP accomplishments included:

• Educational presentations and outreach activities to 13 agencies (including Adult Protective Services staff in key locations of the state, NM Prescription Drug Misuse and Overdose Prevention and Pain Management Advisory Council, The State Health Officials Meeting, and 2 cancer related patient groups) reaching approximately 365 individuals; and
• On-going Customer Service Training for internal employees.