The Rio Arriba County Health and Human Services Department was able to quickly respond to the challenges posed by the COVID-19 pandemic because of infrastructure the County relied on to combat the opioid epidemic.
County Health and Human Services Director Lauren Reichelt said May 7 that the Rio Arriba County Health Council grew accustomed to assembling task forces to solve problems during the opioid epidemic.
Teams of providers and officials would come together to figure out how to get the opiate overdose-reversing drug Naloxone, commonly known as Narcan, on the street, and how to divert people from the jail system.
When the pandemic hit, the Health Council pulled together another task force.
“We just kind of changed the topic,” Reichelt said. “We started having task forces on ‘How do we manufacture and get (personal protective equipment) out there?’”
As of Tuesday evening, 28 people in the County tested positive for COVID-19. As of Monday, according to Presbyterian Communications Manager Amanda Schoenberg, no one at Española Hospital was hospitalized with the virus.
1,625 people in the County were tested as of Tuesday evening, which represents only about 4 percent of the County’s population.
The pandemic also affects how the County is able to provide care to those with substance use disorder.
The referral process for treating people with the disorder broke down when people began testing positive in New Mexico, because of the dangers posed by congregate facilities and because there were not enough tests available or isolation protocols in place.
And at the beginning of the crisis especially, the lack of available tests and PPE challenged the County’s ability to fully respond.
“The combined lack of PPE and the inability to provide the level of tests that we need has completely disrupted our protocols,” Reichelt said. “And I hope that one day we will fix the supply chain issues around PPE and testing so we can be as present for the public as we’d like to be.”
The County’s task force worked to significantly decrease the population in the jail and to ensure that Hoy Recovery Center had ways to test individuals and isolate them.
The County Health and Human Services Department is currently working to be able to provide telehealth to individuals for case management and is setting up kiosks that will be sanitized where people can one-by-one access computers to communicate with providers.
The Department is also in a state of transition because the New Mexico Behavioral Health Services Division wants Rio Arriba to be the first county in New Mexico to transition to billing through Medicaid.
The change would allow the Department greater flexibility, because grants, which it currently relies on, are rigid in their requirements and amounts, while Medicaid reimburses providers for approved services, without a cap. So Reichelt said the change would be positive.
The problem is, the Department is now ensnared in state bureaucracy––the state Department of Finance and Administration requires counties to have guaranteed amounts of money when planning and approving budgets, but with Medicaid, there is no guaranteed amount of money.
It is not clear how the transition to Medicaid would work with county budgeting requirements.
Reichelt said she is not sure the Behavioral Health Services Division understands the problem, so the County Health and Human Services Department is caught between the two state departments.
“There have been a lot of bureaucratic snags,” she said. “Given how difficult the situation is, things have worked out pretty well. But there have been moments where we’ve been really frustrated.”