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NMDOH FY18 ANNUAL STRATEGIC PLAN PROGRESS REPORT

The New Mexico Department of Health (NMDOH) Results Scorecard shows the progress we made toward a Healthier New Mexico during fiscal year 2018 (FY18). You can use this Scorecard to learn about the actions we are taking to carry out our Strategic Plan. The Scorecard shows what we are doing and how well we are doing it.

A Result (R) is the condition of well-being we would like to see for the population of New Mexico. An Indicator (I) helps us measure the desired Result in the population. A Program (P) is an organizational unit in our agency that helps us reach the desired Results. A Performance Measure (PM) helps us measure how well a Program is contributing to population health.

A line graph of year-by-year performance is provided for each Indicator and each Performance Measure. On the graph, the solid blue line is our actual performance, and the dashed orange line is our performance target. Each graph's background is colored using three 'color bands': green, yellow, and red. The green color band represents the desired area of performance. The yellow color band represents performance that is near to but short of the desired level of performance. The red color band represents performance that is furthest from the desired level of performance. Several of the Performance Measures are 'Explanatory' measures. For these measures we have not set a performance target. Backgrounds for these graphs are white. 

This Scorecard is interactive. Mouse-clicking on the on the '+' symbol next to the name of the measure you are interested in will display the graph of our performance. To access a narrative description of our plan and our progress on the measure, mouse-click on the name of the program or measure you are interested in. 

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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 FY18, some of PHD’s accomplishments included:

  • The Harm Reduction Program worked to reduced opioid overdose deaths through widespread distribution of Naloxone (an opioid antagonist) and training on its use. The result in FY18 was over 1,600 reported overdose reversals.
  • The Prevention of Child abuse and Neglect Extension for Community Healthcare Outcomes (ECHO) pilot concluded on November 15, 2017 with the graduation of 16 Community Health Workers and Home Visitors. The training topics included the background and prevalence of child maltreatment, recognizing risk and protective factors, child development, social determinants of health, early intervention, reflective practice to name a few. 
  • Teens enrolled in Wyman’s Teen Outreach Program (TOP®) through the Family Planning Program’s educational contracts completed over 7,613 hours of community service across NM in FY 18.  Community Service Learning (CSL) gives teens an opportunity to practice new skills, foster a sense of self -efficacy, and feel a sense of purpose in their role in the community.  
  • The New Mexico Breast and Cervical Cancer Early Detection (BCC) Program provided free, age-appropriate breast and cervical cancer screening and diagnostic services to 5,700 low-income women in FY18. The BCC Program also provided support for 465 low-income New Mexico women to receive clinic-based patient navigation services to address the barriers preventing them from obtaining breast and cervical cancer screening and/or diagnostic services.
  • The Diabetes Prevention and Control Program worked with its partners to improve access to, and participation in, the National Diabetes Prevention Program (NDPP) for adults with prediabetes or at high risk for diabetes. by establishing three new NDPP delivery sites.
  • The Albuquerque  Water Utility Authority began fluoridating its systems on July 1, 2018.
  • The Tobacco Use and Prevention and Control Program and the Office of Oral Health staff developed and implemented an on line Tobacco Cessation Training Program for dental providers. The training is available for dental assistants, dental hygienists, dentists, and office staff.  Dental hygienists and dentists receive 1  CEU.

 

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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
During FY18, some of ERD’s accomplishments included:
  • Program evaluation capacity is being enhanced through federal funding.
  • New Mexico's drug overdose death rate dropped in the state rankings from 8th highest in 2015 to 12th in 2016. 
  • The number and percentage of retail pharmacies that dispense naloxone has increased substantially from 26.5% in FY16 to 60.9 % in FY17 and still climbing at 72.6 % for FY18.
  • Emergency department syndromic surveillance uses are expanding to tracking non-fatal overdose, suicide attempts, and influenza.
  • A new trauma center, the first in Doña Ana County, was designated.
  • Crisis standards of care are being developed to increase the number of tools available to be used in a major public health emergency.
  • The older adult falls death rate decreased continues to decrease from 91.6 deaths/100,000 in 2016 to 87.9 deaths/100,000 in 2017.  At the same time the number of health care providers and older adults trained in evidence based fall prevention approach continues to increase with a total of 710 at the close of FY18.
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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 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.
    • All sections have filled vacant positions and continue to cross-train analysts across bureau sections.
    • Completed validations for the identification of hepatitis B surface antigens, carbapenem-resistance in bacterial culture, and molecular testing for antibiotic resistance genes in bacteria.
    • Prepared and presented a poster at the 2018 Association of Public Health Laboratories annual meeting describing rabies testing.
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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 FY18, some of FMD's accomplishments included:

Facilities Management

  • Master planning for 3 of DOH's largest healthcare facilities began, to ensure the facilities keep pace with industry standards for care and address evolving program needs well into the future

Turquoise Lodge Hospital

  • Admitted 1,034 New Mexico residents into the Adult Detox program
  • Annual average occupancy was 86%
  • Provided 938 outpatient encounters to residents
  • Identified a location for a new facility where there are opportunities for accreditation and program growth

NM Behavioral Health Institute

  • Celebrated 125 years of service
  • CARE, the adolescent division, successfully certified by the Children, Youth and Families Department
  • Long Term Care successfully surveyed by the Division of Health Improvement
  • Hosted rapid hire recruitment events at least quarterly to recruit direct care staff
  • Focused on nurse retention efforts-implemented a 30, 60, and 90-day post-hire interview process for all new hires and improved unit orientation for new hires

Sequoyah Adolescent Treatment Center

  • Courtyard renovations completed
  • Full 18-months certification received
  • Zero deficiency report received from Licensing
  • 100% of staff trained on Trauma Informed CPI techniques and interventions
  • Students received GED or High School equivalency diplomas while in treatment
  • Most student test results showed 2-3 grade level improvement
  • Teacher named Albuquerque Teacher of the Year 

New Mexico Rehabilitation Center

  • Built stronger relationships with the local healthcare community and referral bases to sustain and improve census and continuum of care
  • Passed accreditation and federal regulatory standards to sustain program and quality of care
  • Reopened Social/Residential inpatient rehab for substance misuse patients
  • Enhanced call intake/admission process

Fort Bayard Medical Center

  • Successfully passed annual Centers for Medicare and Medicaid Services, Veterans' Administration, and Life Safety Code surveys
  • Recognized by Abaqis for Quality Assurance and Performance Improvement for three quarters

Los Lunas Community Program

  • Finance, Quality, Clinical, and Nursing staff moved to the Campus from a privately leased building
  • Comprehensive reviews of environment of care in the 24 homes began, to ensure the safety and proper care of consumers
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What We Do
The Developmental Disabilities Supports Division (DDSD) effectively administers a system of person-centered community supports and services that promotes positive outcomes for all stakeholders.
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, 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 operation 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.
  • In March, the Developmental Disabilities Waiver standards were revised. New language was added about Person-Centered Thinking, Person-Centered Planning, and Person-Centered Practice. Language was also clarified to explain how to arrive at and document the process of making an informed choice about employment and decisions about other life areas.  Each team member plays a role in promoting employment and reducing barriers.
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What We Do

The Division of Health Improvement (DHI) plays a critical role in 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 40,000 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 FY18, some of DHI's accomplishments included:

Caregiver's Criminal History Screening Program (CCHSP)

  • Processed 40,488 Caregiver Criminal History Screening Background Checks with an average processing time of one day.

Health Facility Licensing and Certification (HFLC)

  • Processed:  2,354 Certified Nurse Aide (CNA) Applications, over 1,400+ CNA reciprocity and verification requests, and 2,628 CNA renewal applications. 
  • Received and triaged over 15,000 reports regarding allegations of abuse, neglect, exploitation, injuries of unknown origin, and other reportable incidents in health facilities.
  • Received and processed 1,295 health facility hotline calls resulting in 195 onsite investigations being conducted.
  • The facility complaints unit completed 14,866 internal desk reviews of incidents.
  • Added four new Assisted Living Facility Surveyor positions.
  • Implemented a process to award quality improvement grants to health facilities by utilizing earmarked civil monetary penalty funds in partnership with Centers for Medicare and Medicaid Services (CMS).
  • Assisted in the approval of a CMS grant to provide funding to 20 New Mexico nursing homes for infection control improvement measures.
  • The Life Safety Code Team completed 269 surveys including:  112 recertifications, 88 revisits, 33 initials for new licenses, 30 initials for renovations, and 6 miscellaneous surveys. The plan review section received 108 building plans and approved 96 for new or renovation projects, and processed 159 plan reviews.

Community-Based Waiver Programs:

  • The online Abuse, Neglect and Exploitation (ANE) annual refresher training was activated on 3/1/18.  The online ANE refresher training is now available to all community-based service providers, Developmental Disabilities Supports Division and DHI staff.
  • The Incident Management Bureau  disengaged from Jackson Objective S1.1.2, regarding educating certain groups (i.e. families, guardians, physicians and law enforcement) about IMB and how to recognize and report abuse, neglect and exploitation.
  • The Quality Management Bureau completed a redesign and revisions of survey tools for community living, community inclusion and case management in conjunction with the new Developmental Disability Waiver standards.
  • The Individual Quality Review (IQR) survey team is fully staffed.

 

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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 FY18, some of MCPs accomplishments included:

  • Provided 30 (thirty) educational presentations to approximately 1155 participants.
  • Cross-trained Licensing and Compliance Manager duties with Patient Services Manager duties.
  • Hired numerous key staff including a Medical Director, a Health Educator, an Environmental Scientist, and an Investigator.
  • Implemented strategies to print, fold, and stuff informational patient inserts at the NMDOH mailroom to reduce staff time on patient mailings in the office.
  • Conducted on-going Customer Service Training for internal employees.

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Scorecard Container Measure Action Actual Value Target Value Tag S A m/d/yy m/d/yyyy