The reception desk inside the Health Commons

Health Commons
1500 Idalia NW
Bernalillo, NM 87004
(505) 867 2291
www.sandovalhealth.org

Health Commons serves many needs

—KEIKO OHNUMA

For a poor state, New Mexico has some lavish public facilities. And for a state with such poor health statistics—including worst in the nation for prenatal care—well-funded public health projects abound.

A unique example has for three years been tucked away at the edge of Bernalillo, hidden behind the Sandoval County Judicial Complex on Rio Rancho Boulevard. The Health Commons houses multiple public health agencies in a clean, spacious, enviable office building that gives hardly a clue as to its many functions. Reading the brochures and getting a tour of the facility doesn’t much help sort out exactly who is providing what there.

But it is clear from the steady stream of women and children being ushered into the inner sanctum that a lot of parents come to seek help—and expect to find it. Playrooms, crayons, blocks, and toys are as abundant as files and charts. Most of the staff are female, and nearly all are bilingual.

In the warren of offices zoned by function are housed county and state services ranging from Medicaid enrollment and the federally-funded WIC food program, to family planning, senior services, immunizations, parenting resources, help with medical bills, screening for cancer and STDs, women’s health exams, needle exchange, and public classes including healthy cooking, parenting, scrapbooking, music, and dance.

The complex is unique in that it integrates seamlessly what is provided by Sandoval County’s Community Health Alliance, the state health department’s Public Health Division, and community providers such as Presbyterian Medical Services.

What this means in practice is that agencies in the building work together to provide “a continuum of care,” according to county health department administrator Nicola Baptiste. The goal is to find and help high-need families—especially pregnant women and new mothers—before another generation grows up to develop chronic problems.

If a woman comes in to enroll for Medicaid or WIC, for example, she will be offered free classes in parenting, child development, or cooking; medical screening for herself and shots for her children; a playgroup where she can meet other parents and talk with community counselors; and (in the near future) dental screenings and cleanings for herself and her preschool children.

Case workers assess the woman’s need for financial aid, any indications of domestic violence or behavioral problems in children, and a half dozen other criteria—and then meet with each other at the end of the day to share notes and develop a plan of action.

Services are not limited to poor women and children. Since the Health Commons houses state and county health programs as well as the Sandoval Family Support Program, any resident can get Pap smears, screening for cancer or STDs, domestic violence counseling, or take classes for free or on a sliding scale—which is significant at a time when more than a quarter of Sandoval County residents report not being able to get needed health care. Of that number, nearly three-quarters have no health insurance, according to the 2007 Community Health Alliance survey.

“We’re getting a lot of people laid off from Intel,” Baptiste notes.

She credits a forward-looking County Commission and the advocacy of County Manager Debbie Hays in helping to advance the mission of the Maternal Child Health (MCH) council—established at the county level by a 1991 state law—beyond just prenatal care. “We realized we couldn’t look at moms and kids outside the context of the family,” she said.

The county agreed to define health broadly, to include factors affecting quality of life for the whole family, from financial need to psychosocial environment.

“We are very lucky to have a county government that has been absolutely supportive of our mission,” Baptiste says. And central to that goal was having one building to house a range of public services.

The county provided the land, and the state allocated $1.2 million to build the Health Commons, completed in November 2004 and being expanded in phases to include a county transportation complex (currently just the three bus lines of the Sandoval Easy Express). The Family Support Program that occupies much of the building counts among its successes the unique public/private partnership behind its model of integrated health care.

The Health Commons serves about thirteen hundred people a month in Sandoval County.

As the nation debates again various proposals for a universal system of health care coverage, “we definitely work within the systems as they are,” Baptiste says of the health alliance. “No one knows what’s coming, but we feel we can model what works—and what works is integrated care.”

Legislative session in January focuses on health care reform proposals

—JEFF RADFORD, CONDENSED FROM DECEMBER 15 CORRALES COMMENT

Health care reform is expected to dominate the 2008 session of the New Mexico Legislature, and Corrales’s State Senator, Steve Komadina, is already in the thick of it.

He briefed the Mayor and Village Council last month about the status of proposals to address the state’s health care dilemmas, saying he was meeting almost daily on the topic.

Senator Komadina said he was awaiting Governor Bill Richardson’s bill on health care for it to be considered by his Health and Human Services Interim Committee.

When drafts of the governor’s proposals circulated this fall, a highlight was mandatory health insurance coverage for all New Mexicans, similar to mandatory auto insurance for drivers.

That requirement would be buffered by price controls and other limitations on the insurance industry set by a proposed New Mexico Health Care Authority.

Komadina explained that Richardson has consistently opposed a “single payer” system that eliminates the insurance industry by enrolling nearly all New Mexicans in a single, state-administered risk pool.

Instead, the Richardson bill to be introduced in the 2008 legislative session will call for creation of the health care authority to set policy and requirements, but not to run a state system.

Among the requirements for insurance companies would be insistence that no one be denied coverage. Companies could no longer deny coverage for pre-existing conditions, for example, and could not set unreasonably high premiums to exclude people with serious medical conditions.

According to the Richardson plan, insurance companies would have to limit their overhead costs to just fifteen percent of income from premiums. That is, the insurance companies would have to pay out at least eighty-five percent of what they collect as premiums for actual patient care.

Four main components make up the Richardson plan: insurance reform; phased-in participation; transition to electronic claims and records; and creation of a Health Coverage Authority.

Last November, the Village of Corrales joined 126 other organizations and public bodies in calling for a New Mexico version of universal health care. The Village Council adopted a resolution on November 28, 2007 supporting the Health Security Act which will be introduced again in the 2008 session of the New Mexico legislature.

The resolution calls for “a comprehensive solution enabling New Mexico to set up its own health care plan that would guarantee that all New Mexicans—regardless of age, employment, or health status—will have comprehensive, affordable, and quality health coverage.”

The Corrales-based Health Security for New Mexicans Campaign has built grass-roots support for the bill over the past six years. The resolution from the Corrales council was part of that process aimed at lobbying for passage of the act.

If that bill, rather than the governor’s, passes and subsequent economic analyses demonstrate it can be funded, citizens of New Mexico would have universal health care within four years.

A fact sheet on the Health Security Act (available from Health Security for New Mexicans Campaign, PO Box 2606, Corrales NM 87048) provides more details about the proposal. It explains the act’s “go slow” approach to implementation and provisions for cancelling it if it can’t be implemented. It will take three years before the plan may be ready to begin operations. The fact sheet explains that the act would “guarantee choice of provider even across state lines; guarantee a good benefit package that must be as comprehensive as the services offered state employees; preserve the private delivery system (private physicians, hospitals, etc.); and provide strong protections for retirees.”

Corrales’s Mary Feldblum reported to the Sandoval County Commission this summer on progress toward health care reform, offering an update on the Health Security for New Mexicans Campaign. She thanked the commission for its earlier endorsement of the legislation her coalition has developed with input from around the state. Feldblum said a few days before her presentation to the commission, “[This is] a really important decision to make. Are we going to continue to subsidize a failing private insurance system, or are we going to do something really different?

“It’s we, the people, of New Mexico that need to make that decision. It’s not the legislature; it’s not the governor, it’s us. We’re going to have to live with the system, so we need to communicate that message loud and clear to people who are our political servants.”

Feldblum’s report to the County Commission came amid an intensifying effort to build grass-roots support for health care reform in New Mexico.

A primary objective of that effort is to explain results of the recently completed study that compared three models for attaining universal coverage. Last year, the state legislature authorized such a comparative study of these models:

• A publicly administered cooperative system as proposed in the Health Security Act;

• A state-subsidized voucher system whereby people would buy insurance plans screened by a state agency, as proposed in the Health Choices Plan; and

• An expansion of existing public programs for treatment of the uninsured, referred to as the New Mexico Health Coverage Plan.

This summer, the consulting firm Mathematica Policy Research released a final draft of its report entitled “Quantitative and Comparative Analysis of Reform Options for Extending Health Care Coverage in New Mexico.” Mathematica’s analysts found that the Health Security proposal would be the least expensive way to achieve universal medical coverage.

Feldblum explained that “a 1994 New Mexico study by the independent think-tank The Lewin Group estimated that $4.6 billion could have been saved by 2004 had all New Mexicans been under one plan by 1997.

Feldblum and other advocates of the Health Security for New Mexicans Campaign lobbied hard for passage of the bill last year, but it was eventually sidetracked so that the comparative study could be done.

“The bill passed its first committee in each house despite the fact that [Health] Secretary Pam Hyde and the insurance industry were saying ‘wait for the study.’ That’s ultimately what delayed passage of the act,” Feldblum explained.

“So now the results of that study are out, and the Health Security Act is the only model looked at that actually saves money and covers everyone.”

But that doesn’t mean the act will pass next time, she warned, because the insurance industry lobbyists are still very influential, and the governor’s bill would require all New Mexicans to buy health insurance.

She urged people who want a real overhaul of the health care system in New Mexico to call their legislators. People can reach her at the Health Security for New Mexicans Campaign by calling 897-1803.