LAS CRUCES - Cecilia Sharbutt's son Samuel received an autism diagnosis shortly before turning 3.

Sharbutt knew more about autism than many, thanks to her 10 years as an educational assistant for special needs students in Las Cruces Public Schools. She figured she knew the steps ahead: locating medical experts to manage behaviors and boost Samuel's prospects for success.

Additional diagnoses followed: attention deficit hyperactivity disorder, sensory processing disorder, oppositional defiant disorder, and a rare chromosomal condition. Each brought its own treatment spectrum, demands, and challenges. Autism is already among the trickiest neurodevelopmental disorders to manage. Now Sharbutt faced a tangled mix of medical and behavioral issues that felt overwhelming.

"Where do I turn?" she remembers asking herself desperately. "What steps do I take? How can I support my child? What does he truly need? These questions pile up, and you only grasp the difficulty when it hits your own family."

Parents and foster parents statewide have encountered massive hurdles in pinpointing children's mental and behavioral health issues and accessing services, largely due to dire shortages of providers. The launch of a comprehensive statewide care system has lagged years behind, hampered by setbacks and bureaucratic snags.

Recently, a drawn-out contracting conflict between the New Mexico Children, Youth and Families Department and the group handling credentials for family peer support workers and other behavioral health professionals risked affecting families like Sharbutt's. CYFD awarded a credentialing contract last month for the ongoing fiscal year, but another will be needed soon for the new fiscal year beginning July 1.

Sharbutt scoured online directories for autism services and specialized clinicians - providers scarce in Las Cruces. Those efforts yielded nothing. Endless calls to physicians' offices proved fruitless too. The strain of the hunt eventually triggered strokes for her, she shared.

"Some nights, I'd stay awake crying, feeling utterly isolated," Sharbutt said in an interview. "No matter who I consulted, answers were nowhere. It's like shouting in a packed room with no one listening."

While Sharbutt hunted for aid, Samuel's behaviors intensified. His mother recounted one classroom incident involving physical restraint, resulting in bruises and heightened panic. Challenges persisted at home too, prompting multiple 911 calls for ambulance and crisis teams.

Years into her quest, Sharbutt discovered the state's specialized workforce: family peer support workers trained to find treatments for children and coordinate care plans.

She connected with Monica Miura, an Albuquerque-based family peer support worker. Miura pinpointed a range of services for Samuel and assisted with enrollment - in-home applied behavioral analysis, occupational therapy, physical therapy, speech therapy, and various specialty cares, all Medicaid-funded. Miura also aided in arranging school-accompanying behavioral therapists.

Professionals like Miura play a key role in New Mexico's push for a revamped youth mental and behavioral health system.

State Struggles to Keep Pace

In 2020, CYFD and the state Health Care Authority pledged to establish "an effective system for community-based mental and behavioral health services" for all New Mexico youth. This stemmed from the Kevin S. lawsuit settlement, which charged the state with trapping foster children in a downward spiral of deteriorating physical, mental, and behavioral health.

Central to this was high-fidelity wraparound services, offering tailored support for youth with intricate needs. Wrap facilitators, certified by the credentialing board, were essential to these offerings.

"You often can't even start without experts like family peer support workers," noted George Davis, CYFD's ex-psychiatry chief and a Kevin S. lawsuit plaintiff driving the settlement for enhanced wraparound care.

Though not formally in the Kevin S. terms, family peer support workers often assist foster parents in obtaining services. Many wraparound plans mandate their involvement for Medicaid billing.

Yet since the settlement, the state has faltered on promises, with foster youth receiving these services plummeting, per independent monitors.

In 2024, the most recent data year, just 53 foster children got high-fidelity wraparound services, versus 149 in 2019.

Contracting Standoff

Last year brought fresh obstacles to service delivery.

CYFD failed to contract with the New Mexico Credentialing Board for Behavioral Health Professionals at the fiscal year's July 1 start. Lacking funds, the board limped along for months.

On March 23, it halted certifications and renewals - a step that imperiled behavioral health services statewide. Family peer support workers, wrap facilitators, and others faced job losses without credentials.

The board sought back pay, secured in a CYFD contract signed April 28. It runs only to July's end, requiring a fresh process for fiscal year 2027.

CYFD spokesman Jake Thompson attributed the delay to prolonged talks, legal checks, and more.

"They're stepping up now," said Miura, a past board member. "But this isn't how business should run. They've repeated this with other contractors this year."

"This buys just months," Miura added about the deal. "It's temporary. We must ensure CYFD contracts promptly without harming workers. Will we face this again July 1?"

Thompson noted ongoing talks for the next contract, anticipating no hitches.

"The department commits to timely credentialing for children's behavioral health staff," he stated.

Essential Support

New Mexico counties suffer acute shortages of psychiatrists, pediatricians, counselors, and behavioral health experts. Las Cruces faces some of the worst - a New Mexico State University study ranked Doña Ana County second for psychiatrist deficits.

This fuels a crisis for parents of disabled children, hit with endless waits and enrollment labyrinths. Lists stretch over a year.

In this landscape, Sharbutt said a family peer support worker was indispensable for her son's care.

Challenges linger.

Samuel has missed nearly two years of early and periodic screening, diagnostic, and treatment services - EPSDT - meant for ongoing mental, dental, and medical care for kids.

"Many local families need these programs, but no agencies deliver," Sharbutt noted.

Progress marks Samuel's journey since diagnosis. Teachers once predicting institutionalization now praise his strides. Behaviors have faded; he excels in science beyond grade level.

He's mastered major constellations - Orion tops the list - and joined the school science club last year at his teacher's behest. He excels at film and book plot recaps, aspiring to filmmaking.

"We all dream big for our kids, and hearing limits crushes that," Sharbutt reflected. "I'll never cap my son's potential. Other parents share this; I hope they access the help I found."