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SPONSOR B. Sanchez
SHORT TITLE Bilingual Behavioral Health Professionals
APPROPRIATION (dollars in thousands)
or Non-Rec
(Parenthesis ( ) Indicate Expenditure Decreases)
Duplicates HJM 41
LFC Files
Responses Received From
Health Policy Commission (HPC)
Department of Health (DOH)
Public Education Department (PED)
Synopsis of Bill
Senate Joint Memorial 32 requests HPC to conduct a study of bilingual behavioral health profes-
sionals in the state and the barriers to recruiting and retaining adequate numbers of such practi-
tioners. The memorial requests a multi-agency study address the impact of the current shortage
on the mental health of New Mexico residents and HPC submit a report of its findings and rec-
ommendations to the Health and Human Services Committee by November, 2006.
Although there is no appropriation associated with the joint memorial, HPC indicates, depending
upon the strategy employed to quantify the degree of shortage of behavioral health professionals
in New Mexico, HPC may be required to expend resources for outside consulting and data com-
pilation assistance from an entity such as the Center for Health Care Work Force Studies.
Senate Joint Memorial 32 – Page
HPC notes a substantial and growing body of research (Kaiser Family Foundation 2002-06) indi-
cates that “race/ethnicity – independent of clinical and socioeconomic factors – continues to mat-
ter in the U.S. health care system. Racial/ethnic background continues to affect access to health
care and the quality of care obtained.” While the evidence varies for specific conditions and ra-
cial/ethnic minority groups, the data are sufficiently compelling to begin undertaking actions to
systematically and aggressively eliminate disparities in needed medical care through targeted
strategies of workforce development.
Additionally, New Mexico has a long history of health professional shortages, especially in the
behavioral health arena and especially in rural locations of the state. HPC studies in the past have
looked at and made recommendations regarding physicians, nurses, dentists, and other profes-
sionals. However, HPC has not done a study of behavioral health professionals. No firm data ex-
ists about the degree of shortage, much less the degree of shortage when factoring in bilingual
supply of behavioral health providers. The memorial asks that this be done in conjunction with
the impact that shortage has on New Mexicans health status.
DOH states the U.S. Census Bureau 2000 data indicates that 40 percent of New Mexico’s popu-
lation is Hispanic, 9 percent are Native American, and 1 percent are Asian or Pacific Islander.
Census data on language indicates that 37 percent of the population of New Mexico speaks a lan-
guage other than English at home (though not necessarily to the exclusion of English). The Of-
fice of Minority Health of the U.S. Department or Health and Human Services stresses that for
improved outcomes, from mental health and substance abuse treatment, services must be cultur-
ally competent and linguistically appropriate. The lack of availability of linguistically appropri-
ate services contributes to health care disparities experienced by these populations.
DOH also notes similar work has already been done by the Behavioral Health Workforce Group
in response to Executive order 2004-062. Issues proposed to be identified in the bill have al-
ready been identified in the workforce report and additional work in this area would be duplica-
Issues in the bill identified as areas to address will be included in an action plan developed from
the Workforce report and coordinated through the Behavioral Health Collaborative.
The Behavioral Health Collaborative will dedicate one staff member to work exclusively with
the Native American communities and will assure that work programs are developed to address
all cultural and language issues, as well as overall work force capacity problems.
The following statistics were provided by the Bilingual and Multicultural Bureau of PED:
There are 65,128 English language learners in New Mexico, some of whom may be
orally proficient in English but are unable to read and write with proficiency in English
(Bilingual and Multicultural Bureau of PED, 2005 data).
There are 10,996 known immigrant students in New Mexico (Bilingual and Multicultural
Bureau of PED, 2005 data).
There are 2,200 migrant students in New Mexico and about 50 percent of those are Eng-
lish language learners (Title I, Migrant population data 2005, PED).
Senate Joint Memorial 32 – Page
In order to meet the behavioral health needs of the citizens of New Mexico it is critical
that an adequate number of bilingual professionals are available to address such issues as
substance abuse, suicide and other mental health issues in a culturally competent manner.
Hispanics make up 43.2 percent of New Mexico’s population (2003 population estimates
from the U.S. Census Bureau – New Mexico Selected Health Statistics Annual Report for
PED also notes data on the impact of the lack of bilingual behavioral health providers is lacking
and difficult to collect.
As the lead agency for this memorial, HPC indicates it will be responsible for providing inten-
sive staff support to facilitate meetings, follow up on task assignments, conduct research, as well
as drafting and distributing the final report. There will need to be a very close working relation-
ship with and participation of the Human Services Department, the Department of Health, the
New Mexico Hospital and Health Systems Association, statewide organizations representing be-
havioral health professionals, consumers, and others with knowledge and expertise in the field of
behavioral health.
House Joint Memorial 41 duplicates Senate Joint Memorial 32.
HPC states, in order to quantify the shortage of mental health personnel, it may be helpful to add
the Office of Workforce Training and Development, a representative from the Governor’s Of-
fice, and a representative from the Children, Youth and Families Department named as agency
participants in the memorial.
HPC notes it, through the joint memorial, has been requested to conduct a study of the impor-
tance of and the barriers to meeting the need for recruiting and retaining an adequate supply of
bilingual behavioral health professionals in New Mexico. The study should also address the im-
pact of a shortage of bilingual health care professionals on the mental health of New Mexico
Currently, HPC notes there is no firm data with respect to the actual number of behavioral health
professionals by county actually in practice. Licensure data is not a reliable indicator of how
many behavioral health professionals are actually in practice and where the service is being pro-
vided. Consequently, the degree of shortage of behavioral health professionals itself, much less
bilingual behavioral health professionals, is not known. Both would need to be quantified before
a strategy could be established to resolve the shortage. The process of collecting this data will
likely identify many of the barriers to meeting the need for recruiting and retaining an adequate
supply of bilingual behavioral health professionals called for in the memorial.
Additionally, living in a diverse state inevitably requires working closely with people from a va-
Senate Joint Memorial 32 – Page
riety of backgrounds. In healthcare, it means that providers must care for patients whose race,
ethnicity, and language are often different from their own. What this does to the often compli-
cated interactions that take place between a behavioral health provider and a patient is not
known. The memorial will attempt to answer this issue.
HPC states cultural competence is often defined as “the demonstrated awareness and integration
of three population-specific issues: health-related beliefs and cultural values, disease incidence
and prevalence, and treatment efficacy. But perhaps the most significant aspect of this concept is
the inclusion and integration of the three areas that are usually considered separately when they
are considered at all (Lavizzo-Mourey and Mackenzie, 1996).” The memorial will attempt to de-
scribe the impact of the lack of cultural competence and absence of bilingual providers has on
the health status of New Mexicans.
HPC data shows health care organizations—health plans, hospitals, community
health centers,
clinics, and group practices—can play
an important role in the elimination of racial/ethnic dis-
in health care. There are now a number of examples of organizations
that have been suc-
cessful in reducing or eliminating disparities,
and a number of published examples of how quality
initiatives can improve care for members of targeted minority
groups, thereby con-
tributing to the elimination of disparities. (Health Affairs Volume 24 # 2).
Finally, HPC notes the quality of communication between patients and clinicians
can have a ma-
jor impact on health outcomes, and limited English
proficiency can interfere with effective com-
munication. According to Health Affairs, more
than ten million U.S. residents speak English
poorly or not
at all, constituting a language chasm in the health care system.
A study in Health
Affairs shows evidence on the link between linguistic
competence and health care quality and the
impact of particular
language-assistance strategies. Drawing on the experiences of
fourteen health
plans that have been at the forefront of linguistic
competence efforts, the study has lessons for
plans, purchasers,
policymakers, and researchers on ways to improve the availability
and quality
of interpreter services.