As the U.S. government abandoned its response to the ongoing SARS-CoV-2 pandemic, many federally funded public health services have been diminished or gone away.
A large federal grant from the Centers for Disease Control and Prevention has allowed groups in New Mexico devoted to public health in local communities to mitigate the effects of the virus and COVID-19, the disease it causes. But that grant will run out in May 2024.
Now, a group of New Mexico lawmakers are getting ready to boost state funding to not only make up for the grant’s end but also fully fund health councils so they can achieve their mission.
Rep. Anthony Allison (D-Fruitland) said Thursday he will for a third time introduce legislation to increase the amount of state money going to 33 health councils operating in every county in New Mexico, and another nine based in tribal nations around the state, who work alongside the New Mexico Department of Health.
“We’re not done,” Allison (Diné) said in a phone interview. “If we’re going to go down, we’re going to go down fighting. That’s how much I believe in the health councils.”
He will have backup in the upcoming session from Rep. Elizabeth Thomson (D-Albuquerque), who co-sponsored Allison’s bill to fund public health councils last session. She said the only people who truly know what’s going on in local communities and tribal nations are those who are there every day.
“We really need to hear the voices of the people who are living it every day,” Thomson said. “Unless they come up with another way, the only way we’re really able to get that vital information, in my mind, is from the people who live there, and we need to fund them to do it.”
Allison said he will also be joined by Sens. Elizabeth Stefanics (D-Albuquerque) and Siah Correa Hemphill (D-Silver City).
In Allison’s district, where the majority of residents are Diné people, and many others across the state encompassing the Pueblos, health councils have been “the frontline defense against COVID,” he said.
We’re not done. If we’re going to go down, we’re going to go down fighting. That’s how much I believe in the health councils.
– Rep. Anthony Allison (D-Fruitland)
They serve as the public health hubs for local communities, and did COVID contact tracing. In 2022, health councils organized more than 24,000 vaccine equity events, and helped get more than 345,000 New Mexicans vaccinated, independent of vaccinations done by hospitals or other entities.
“The health councils assisted with behavioral and mental health, and if we addressed mental health and behavioral health, we would not have the problems of gun violence, domestic violence, and things like that,” Allison said.
Without sustained funding every year, that work would be disrupted, according to Valeria Alarcón, executive director of the New Mexico Alliance of Health Councils.
Next session will ‘make or break’ councils
The upcoming legislative session will determine the future of health councils, Alarcón said.
“This is the legislative session that is going to make or break this very instrumental mechanism of public health,” Alarcón said.
What’s more, the New Mexico Department of Health did not include health councils in its proposed budget lawmakers will consider in January.
Like all state agencies do every year, the health department on Sept. 1 submitted its proposed budget for the upcoming fiscal year to the Legislative Finance Committee (LFC).
Source New Mexico reviewed the 141-page appropriation request, and could not find any specific appropriation for health councils. In a written statement, a spokesperson for the state department of health did not directly respond to a question asking if there is one.
“NMDOH is actively pursuing additional funding for Health Councils, collaborating with partners like the New Mexico Alliance of Health Councils, the Centers for Health Innovation, and funders,” Department of Health spokesperson Jodi McGinnis Porter said. “Although these sources have not materialized yet, we remain committed to supporting Health Councils.”
Alarcón has presented data to lawmakers, most recently on Sept. 19, showing the amount of state funding for each public health council only covers one part-time worker and is not enough to meet their duties under state law.
McGinnis Porter said the department of health set aside about $6.5 million for health councils over the last three years. That money comes from a grant made possible by a federal law passed in 2021 tied to the federal public health emergency, which was declared over earlier this year.
The grant runs out on May 31, 2024, according to the CDC.
It’s like asking NMDOH, health councils — all of us, all these partners — to go run a marathon on all these urgent matters in public health, but I’m going to cut all your legs off, so good luck in finishing the marathon.
– Valeria Alarcón, executive director of the New Mexico Alliance of Health Councils
The drying up grant was meant to “enhance the capacity and technical support for health councils to better address community health priorities in the face of COVID,” McGinnis Porter said. It also supported other local groups “in driving the desired system changes to improve health for our communities,” she said.
“As the COVID-19 Public Health Emergency ends, states are increasingly relying on state legislature general funds to sustain critical systems for our most vulnerable communities,” McGinnis Porter said. “Like many states, New Mexico lacks the capacity to fully replace federal funds with state resources.”
The New Mexico Department of Health’s total budget this year exceeded $771 million, with almost half funded by the state Legislature and the rest coming from the federal government.
The state has no reason to be stingy with money, with billions of dollars in savings and billions more coming from historic oil and gas extraction.
With the CDC funding going away, and without some kind of replacement, two-thirds of the health councils could dissolve in May 2024, Alarcón said. If the Legislature doesn’t fund them, the people doing the volunteer work for them will burn out, Thomson said.
“It’s like asking NMDOH, health councils — all of us, all these partners — to go run a marathon on all these urgent matters in public health, but I’m going to cut all your legs off, so good luck in finishing the marathon,” she said.
Community health planning at stake
The Department of Health’s proposed budget does contain references to the State Health Improvement Plan, which is informed by local health councils’ reporting on shortcomings in local health systems.
Health councils’ purpose under state law, McGinnis Porter said, is to develop community health plans and work with the state to improve communities’ health. The department of health in 2021 launched an initiative to make the plan better through community input, she said.
State health officials also lead a workgroup who coordinates over 200 organizations including the health councils, hospitals, federally qualified health centers and tribal communities, McGinnis Porter said.
Source New Mexico also asked the state health agency how it will create the State Health Improvement Plan without the health councils that could dissolve when federal funding runs out.
McGinnis Porter said the department of health does collaboration between the agency and health councils that promote equity and “address social determinants of health as they relate to COVID-19 health disparities among populations at higher risk and that are underserved.”
However, all of that work is at stake if the state government doesn’t fund it, according to Alarcón, and that the lack of state investment could harm community members and the health systems people need.
“I just can’t seem to get an understanding of why there’s a lack of recognition of the value of this work, given all of the public health priorities and crises in New Mexico,” Alarcón said.
Pandemic won’t be solved by ignoring it
In his first session after he was elected to the Legislature in 2019, Allison carried a bill that would have set aside $1 million for health councils. It got through one committee in the House.
In his fifth session earlier this year, Allison tried again and asked for $5.25 million.
Allison’s colleagues on the House Appropriations and Finance Committee voted to table the bill, preventing it from getting a vote by the full House of Representatives. He said he was “led to believe that I did not need to worry, that we were going to fund health councils through DOH.”
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The head of the committee told reporters at the time it was a “temporary table,” and the funding could have been put into the state budget later in the session.
But that did not happen.
“All of a sudden, the tables turned on me,” Allison said. “This is my own committee, my fellow colleagues, and I told them I was very, very upset with the decision they had to give me on the last day, when they led me to believe all along that we were going to get funded.”
Over the summer, Allison said he and his allies decided, “You know what, we’re going to make them pay for it.” So the draft legislation will ask for $6.6 million in annual funding, one-and-a-half times the amount they asked for last time.
In a Legislative Finance Committee hearing scheduled in November, Allison expects “a final plea” from Alarcón and her team. Thomson is vice chair of the interim Legislative Health and Human Services Committee, and said she will have a chance to present her priorities to LFC this month.
He said the COVID-19 pandemic is still happening, “and we’re not going to solve it if we ignore it.”
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