Alta Vista Regional Hospital told the New Mexico House Health & Human Services Committee on July 16 that patients with primary behavioral-health needs account for a far larger share of its transfers than national norms, placing pressure on emergency staff and local transport resources.
Chief Executive Officer Helen Ballantyne told lawmakers that 17 percent of the hospital's transfers in 2024 had a primary behavioral-health diagnosis and that in 2025 year-to-date that share was approximately 18.8 percent. Ballantyne contrasted those rates with a national average she cited of 1 to 2 percent of ED visits resulting in behavioral-health transfers.
Ballantyne described operational limits for critical-access hospitals: Medicare-designated critical access status creates length-of-stay restrictions that make it difficult to hold patients who need longer behavioral-health observation. She said New Mexico Behavioral Health Institute (NMBHI) admits only court-ordered patients and that beds for voluntary, non–court-ordered admissions are not locally available.
The hospital relayed a recent episode in which an arriving patient became homicidal, assaulted and strangled a staff member, and required an extended hold at the facility while staff and emergency responders sought a transfer. Ballantyne said that such incidents illustrate the need for more local inpatient behavioral-health capacity and better transfer pathways.
Transport and EMS capacity also factored prominently. Witnesses at the hearing said rural ambulance shortages sometimes force reliance on air medical transport that may not be medically necessary but is used because ambulances and local EMS crews are not available; that raises costs for patients and payers. Committee members told stories of air-ambulance bills in the tens of thousands of dollars and urged tighter oversight of charges.
Ballantyne said about 5.4 behavioral-health transfers per week are occurring and that efforts are underway to negotiate a local air-transport base and to create a behavioral-health umbrella program to coordinate inpatient and outpatient supports, case management and substance-use treatment so patients are less likely to bounce back into emergency care.
Hospital leaders also said credentialing issues with a Medicaid managed-care organization have left $3.3 million in unbilled receivables attributed to Turquoise Care's migration to a new provider portal; the hospital asked for state support in addressing MCO billing and credentialing problems.
Alta Vista asked legislators for help with three priorities: (1) more local behavioral-health bed capacity or better direct-admit pathways to state behavioral-health services, (2) strengthened rural EMS and transport including consideration of an air-transport base or better ambulance distribution, and (3) support for recruitment, housing and loan-repayment incentives to retain clinical staff.