Providers say Health Department slow to give out funds for school health centers
Margaret O'Hara, The Santa Fe New Mexican
Updated 5 min read
Jan. 20—ALBUQUERQUE — Dan Frampton expects his organization will be out of money by mid-February.
Frampton, a licensed clinical social worker, serves as president of the board of trustees for Breaking the Silence New Mexico, a nonprofit that provides suicide prevention and mental health education to students across the state.
"We literally save lives by the work we do," he said.
The organization, which according to tax documents receives "a substantial part of its support" from public funds, entered a contract in July with the state Department of Health to provide in-school services to students. But Frampton said the department still hasn't paid the $50,000 it owes Breaking the Silence New Mexico.
"We've got about $20,000 left in the books," he said. "So what happens after that?"
Among organizations working in and around schools — including dozens of school-based health centers — Frampton's experience is relatively common: Department of Health grant payments have been delayed since July, providers said.
The problem resulted from the department's slower-than-expected shift to a new administrative services organization, David Barre, a spokesman for the Department of Health, wrote in an email.
In December, the department paid more than $1.7 million to school-based health centers, Barre said, and the administrative services organization has worked to ensure contractors are registered for the department's new payment system.
But nonprofit providers working in schools said they still haven't been paid — and as the legislative session gets underway, they want to ensure the next fiscal year's funds won't arrive six months late.
"It's great that the health centers have gotten paid — and hopefully the different nonprofits will — but we need to find those underlying reasons," Frampton said.
Clinic coordinator Sabrina Owens' school-based health center is located at Robert F. Kennedy Charter School, operating out of a portable building. The center is open to students and families at five public charter schools in Albuquerque's South Valley. In the last school year, Owens said, the portable saw nearly 2,000 office visits, with plans to open up two more clinics.
Things changed this school year. Although Owens said she entered into a contract with the Health Department set to begin July 1, 2023, those payments didn't appear.
Owens started taking out personal loans to float the clinic each month. She paused plans to expand. Staff members — including Owens — decreased their salaries, and the center's doctor refused payment entirely.
Owens' center — like school-based clinics across the state — was finally paid in December.
Bill Wagner, executive director of Centro Sávila, went through something similar, though his organization still hadn't received payment from the Department of Health as of last week.
Centro Sávila provides culturally and linguistically responsive mental health and case management services, particularly for immigrants and refugees.
The lack of payment created logistical challenges for Owens and Wagner: It's impossible to determine staffing needs or plan service offerings when grant payments aren't guaranteed.
"Most nonprofits like mine are running on a very fine line, and it impacts our ability to recruit new staff and to retain existing staff when we have uncertainty about whether or not we're going to get paid for services," Wagner said.
And the financial squeeze — if it resulted in the departure of certain employees or the closure of clinics entirely — could decrease critical services available to vulnerable people, Owens said. In part, she pushed to keep her clinic open to continue serving about 30 students on suicide prevention plans.
"If one kid committed suicide because we closed — because of the state — I couldn't live with that," Owens said.
When students and families don't have access to nonprofit medical care, schools suffer, too, said Anamargarita Otero, the community school coordinator at John Adams Middle School.
Otero argued the Department of Health's late payments undermine the entire community schools framework, a policy favored by the New Mexico Public Education Department. Under such a model, schools strive to ensure not just students but also their families feel buoyed through programs like food and clothing pantries, free tutoring and wellness seminars. Nonprofit health care providers make up an essential piece of this framework, Otero said: They ensure schools can point families to accessible care, from dentistry to therapy.
"In a community school, we rely on these partnerships. We rely on our outside partners to come and help us do things that schools are not built to do," Otero said.
"If our government, if our state Legislature, if the Department of Health doesn't support the nonprofits that come in and do this tremendous heavy lift, how are we going to keep graduating kids? How are we going to keep people healthy enough to be productive members of society?"
Otero, Owens and Wagner are members of Albuquerque Interfaith, a coalition of 22 organizations. Their first ask is speedy payment of the delayed Health Department contracts, said Bob Edgar, an Albuquerque Interfaith board member.
And as payments start to arrive, Edgar said, department officials must ensure timely payments become the norm.
"The system has to be corrected. ... It needs to be sustainable and, to make it sustainable, you have to count on getting paid under contracts that have been approved and money that's been appropriated," he said.
Specifically, Albuquerque Interfaith is pushing to ensure school-based health centers and nonprofit providers are included in conversations on how to ensure the Department of Health's payment system is reliable.
That's something providers are interested in, too.
"We try to partner with the state," Wagner said. "We want to be part of the solution and build a relationship so that we have a coordinated, integrated and sustainable system."
