Public health councils struggle for funding in the Roundhouse

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Advocates for New Mexico’s local community health planning councils are scrambling to revive support after a House panel last week blocked a proposal to finally provide them with the money needed to carry out their public health mission.

Thirty-three health councils operate in every county in New Mexico, and another nine are based in tribal nations around the state, said Gerilyn Antonio, tribal liaison for the New Mexico Alliance of Health Councils.

“They definitely serve a big role in our public health infrastructure,” Antonio said. “It definitely does need to be fully funded.”

Health councils are the lifeline to meeting public health needs in underserved communities including rural parts of the state and border towns, said Valeria Alarcón, executive director of the Alliance.

They serve as the public health hubs for local communities, and did COVID contract tracing, Antonio said. In 2022, health councils organized more than 24,000 vaccine equity events, and helped get more than 345,000 New Mexicans vaccinated, Alarcón said.

When the pandemic started in 2020, the Rio Arriba County Health Council, for example, sewed and distributed free masks when retail workers were prohibited from buying masks to wear at work, was involved in a significant release of people from the county jail, and set up telehealth kiosks for people getting substance use disorder treatment.

Health councils have been critical partners whenever someone needs to convene community members to talk about health issues, but they have been “systematically underfunded,” said Anne Hays Egan, a public health consultant.

Currently, the entire budget for all 42 health councils across the state is just over $544,000, or $12,952 per council.

“There’s not a lot any of us can do with $12,000,” Egan said. “You need to have continuous, baseline funding.”

That level of funding alone is not enough to pay for even one part-time staff, let alone carry out the functions required of health councils in state law, Antonio said, which include reporting on shortcomings in local health systems, coming up with strategies to address them, and offering advice to counties and tribes.

“This takes a level of expertise, experience, competency and skill set to deliver on this work,” Alarcón said, “and it’s one that should really be compensated adequately, and funded.”

A task force created by lawmakers reported last summer the Legislature should create “a sustained, adequate funding stream” for local health councils.

The task force recommended creating a set of best practices for health councils, increasing the minimum state funding for them, setting aside money so their staff can get training, and figuring out what money controlled by the state Department of Health, including Medicaid, can be used by the councils to get large grants.

In their budget recommendations for the upcoming fiscal year, the Legislative Finance Committee recommended increasing health council funding by $100,000, while the governor recommended an increase of $235,000.

But advocates say those meager increases are not enough.

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House Bill 49 would set aside $5.25 million per year to fund the 42 health councils across New Mexico. Each health council would receive $125,000 each year.

The bill would also set aside $500,000 for the DOH to hire a nonprofit to provide training, technical assistance and other support to the local health councils; help create a system to evaluate the councils’ work; and strengthen community-based health planning and self-determination. 

The bill is sponsored by Reps. Anthony Allison (D-Fruitland), D. Wonda Johnson (D-Rehoboth) Elizabeth Thomson (D-Albuquerque), and Sen. Elizabeth Stefanics (D-Cerrillos).

The House Health and Human Services Committee unanimously passed the bill on Jan. 23. However, the House Appropriations and Finance Committee on Feb. 20 voted to table the bill, preventing it from getting a vote by the full House of Representatives.

Committee Chair Nathan Small (D-Las Cruces) said the action taken by the committee was a “temporary table.”

There is still a way to add more money for health councils in the state budget bill called House Bill 2, Small said.

“We can bring this back up if there are changes in the Senate,” Small said.

He said more funding could be put into the budget as it makes its way through the Senate, and then when the two legislative chambers work to merge their budget proposals together, called “reconciliation.”

“This is one of the most challenging things about the committee,” Small told Allison on Feb. 20, “is that we’re not able to fully fund items, therefore, that the bills, especially that are just appropriations, cannot pass through. It doesn’t mean that there won’t be more funding for these purposes that flow this year. It just means that in this fashion, the bill can’t move through this committee.”

Now, advocates are trying to convince members of the Senate Finance Committee to put more funding in House Bill 2, the bill that determines the state budget for the upcoming fiscal year, Alarcón said.

They have been trying to convince members of the committee for the last two weeks, Alarcón said on Thursday.

She said Sens. Siah Correa Hemphill (D-Silver City), Jeff Steinborn (D-Las Cruces), Crystal Diamond (R-Elephant Butte) and Nancy Rodriguez (D-Albuquerque) “have all verbally expressed support for HB 49.”

For a vote to pass on the committee, the advocates would still need to convince two additional members to vote in favor of funding the health councils.

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