House Bill text for HB0784

HOUSE BILL 784

48th legislature - STATE OF NEW MEXICO - first session, 2007

INTRODUCED BY

Ben Lujan

AN ACT

RELATING TO NATIVE AMERICAN HEALTH CARE; ENACTING THE NATIVE AMERICAN HEALTH CARE IMPROVEMENT ACT; CREATING THE NATIVE AMERICAN HEALTH COUNCIL; CREATING A FUND; REQUIRING TRIBAL LIAISON POSITIONS IN CERTAIN DEPARTMENTS; MAKING APPROPRIATIONS.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:

Section 1. [NEW MATERIAL] SHORT TITLE.--Sections 1 through 9 of this act may be cited as the "Native American Health Care Improvement Act".

Section 2. [NEW MATERIAL] FINDINGS.--

A. The federal government has an inherent obligation to improve the health and provide for the general welfare and well-being of the citizens of the United States.

B. The federal government has a trust responsibility to provide health care for and access to health care for Native Americans.

C. Providing accessible health care to all citizens is an essential public health responsibility of all governments, including the government of New Mexico.

D. The federal government continues to withdraw support from the Indian health service, and this lack of support for health care services for Native Americans results in severe disparities in the health of and health care services available to Native Americans when compared with the health of and health care services available to other Americans.

Section 3. [NEW MATERIAL] PURPOSES.--The purposes of the Native American Health Care Improvement Act are to:

A. address the chronic health disparities existing between Native American and other populations that result, in part, from the federal government's failure to fully implement the federal trust responsibilities for Indian health care;

B. promote collaboration to improve disease prevention, the health of Native Americans and access to health care;

C. encourage, through directed funding, the use of existing and evolving technologies to improve health care delivery and services for Native Americans;

D. strengthen the infrastructure for health care delivery programs, health care education and health care research that benefits and improves the health of Native Americans; and

E. strengthen the capacity of state and tribal policymakers to improve health care delivery systems for Native Americans.

Section 4. [NEW MATERIAL] DEFINITIONS.--As used in the Native American Health Care Improvement Act:

A. "applicant" means a tribe, local tribal entities, tribal organizations, off-reservation nonprofit corporate bodies governed by an Indian-controlled board of directors, to the extent that the nonprofit organization is eligible pursuant to the constitution of New Mexico, or an organization that performs research and more than fifty percent of the organization's research is for the purpose of improving health care services to or improving the overall health of Native Americans;

B. "council" means the Native American health council created by the Native American Health Care Improvement Act;

C. "department" means the department of health;

D. "fund" means the Native American health care improvement fund;

E. "governor" means the governor of New Mexico;

F. "Native American" means a person who is a member of a federally recognized tribe or is an Alaskan native and is a resident of New Mexico;

G. "proposal" means a request for funding by an applicant to the council to implement a specific project, program, service or research that provides the Native American community that the applicant represents with:

(1) improved health care delivery;

(2) improved health of Native Americans;

(3) facilities and community-based programs for the provision of health care; or

(4) research or development of tools that can improve either health care delivery or the health of Native Americans;

H. "secretary" means the secretary of health;

I. "stakeholder departments" means the department, the human services department, the aging and long-term services department, the children, youth and families department and the Indian affairs department; and

J. "tribe" means a federally recognized Indian nation, tribe or pueblo, located wholly or partly in New Mexico.

Section 5. [NEW MATERIAL] HEALTH COUNCIL CREATED--MEMBERSHIP--DEPARTMENT OF HEALTH TO STAFF.--

A. The "Native American health council" is created and is administratively attached to the department. The council shall oversee the implementation of the Native American Health Care Improvement Act, and encourage, facilitate and ensure coordination between the stakeholder departments as they interact to implement the Native American Health Care Improvement Act to improve delivery and outcomes of health care for Native American people.

B. The department shall provide staff support for the council. The secretary shall appoint a deputy secretary for Native American health improvement to oversee, manage and implement the activities of the council.

C. The council shall consist of sixteen voting members as follows:

(1) five ex-officio members or their designees:

(a) the secretary, who shall serve as chair of the council;

(b) the secretary of Indian affairs, who shall serve as the vice chair of the council and shall chair meetings in the absence of the chair;

(d) the secretary of human services; and

(e) the secretary of children, youth and families;

(2) eight members, each representing one or more tribes, and one designee for each appointed member who serves in place of the member in the member's absence:

(a) three members representing the nineteen Indian pueblos in New Mexico to be appointed by the governor from lists submitted from the eight northern Indian pueblos council, the southern Indian pueblos council and the all Indian pueblo council;

(b) three members from the Navajo Nation to be appointed by the governor from a list submitted by the president of the Navajo Nation representing geographic distribution of Navajo people in the Navajo Nation located in New Mexico;

(c) one member to be appointed by the governor from a list submitted by the president on behalf of the council of the Jicarilla Apache Nation; and

(d) one member to be appointed by the governor from a list submitted by the president of the Mescalero Apache Tribe;

(3) one member who is engaged in providing health care to Native Americans living within a tribal community to be appointed by the governor;

(4) one member who is engaged in providing health care services to Native Americans living within an urban environment to be appointed by the governor; and

(5) one member who is Native American and a representative of the behavioral health planning council.

D. Members, other than ex-officio members, shall be appointed to terms of two years. A member may serve for two complete terms, not including partial terms served completing a vacated position on the council. Vacancies shall be filled by appointment by the governor for the unexpired term.

E. Council members and designees, other than ex- officio members or their designees, are entitled to per diem and mileage paid from the fund as provided in the Per Diem and Mileage Act and shall receive no other compensation, perquisite or allowance for each day spent in the discharge of their duties.

F. A designee may attend all meetings of the council in order to remain informed about the actions of the council; however, a designee is only a voting member when the designee is attending a meeting in the absence of the member for whom the designee was appointed. Designees shall receive per diem and mileage pursuant to Subsection E of this section for attending a meeting of the council whether acting as a voting member or attending to remain current on the progress of the council.

G. Council members shall organize themselves as they deem necessary to conduct meetings and to implement the provisions of the Native American Health Care Improvement Act. The council shall meet at the call of the chair, but no fewer than four times per year.

H. A quorum is necessary to conduct business. A quorum consists of nine members of the council, one of whom shall be the chair or vice chair. Official action of the council shall be taken upon a majority vote of those present and voting.

Section 6. [NEW MATERIAL] COUNCIL--DUTIES.--The council shall:

A. develop a five-year strategic plan that defines a general strategy for improving health care for Native American residents of New Mexico;

B. identify the priorities that need to be accomplished in the next year to further the purposes of the Native American Health Care Improvement Act;

C. prepare and revise on an annual basis, at a minimum, an action plan that sets forth the actions to be undertaken in the next year that will lead to:

(1) achieving the priorities identified by the council to meet the goals set forth in the strategic plan; and

(2) coordinated use of available funding for improvement of health care delivery and health of Native Americans;

D. issue requests for proposals and review proposals submitted to be funded from grants from the fund or through other sources of capital outlay funding;

E. identify and prioritize for funding, proposals that include:

(1) projects, services or training that advance the goals of the strategic plan and are within the action plan;

(2) capital improvement projects necessary to achieve the goals of the strategic plan and are included in the action plan and develop a prioritized list to submit to the New Mexico finance authority for funding;

(3) research that corresponds to the overall purpose of the Native American Health Care Improvement Act;

(4) capacity building for organizations providing health care services to Native Americans; and

(5) replication of successful models of health care provision in tribal or other Native American communities;

F. conduct training sessions to familiarize applicants and grant recipients with the purposes of the Native American Health Care Improvement Act, the strategic plan and the most recent action plan developed by the council;

G. formalize collaborations among parties involved in Native American health or health care research and provision of Native American health care services, especially in the areas of diabetes, alcohol or substance abuse and other critical behavioral health concerns, disease prevention, post-traumatic stress disorder and other priority health care issues for Native Americans, including health care access and technology;

H. oversee the progress of grants authorized by the council and funded by requiring progress reports twice each fiscal year and identifying benchmarks for grantees to meet that ensure the satisfactory completion of funded projects;

I. disseminate information about successful programs providing Native American health care or improving Native American health to encourage program replication;

J. encourage through funding and other support the cooperative use of existing technology infrastructure and telehealth services;

K. develop collaboration and information sharing consistent with state and federal law regarding medical records and state-tribal agreements; and

L. ensure that all projects, including programs, services or training receiving money from the fund, are fully and satisfactorily completed prior to disbursing final payments for a project, including ensuring the submission of a final report to the council by funded applicants.

Section 7. [NEW MATERIAL] NATIVE AMERICAN HEALTH CARE IMPROVEMENT FUND--CREATED--DISTRIBUTIONS--REQUIREMENTS FOR FUNDING.--

A. The "Native American health care improvement fund" is created in the state treasury for expenditure to plan, develop and coordinate the improvement of health care infrastructure and health care services for Native American people residing in New Mexico and to make grants for projects authorized by the council.

B. The department shall administer the fund.

C. The fund shall consist of money appropriated by the legislature and grants, bequests, gifts or money otherwise distributed to the fund from government or private sources. The earnings from investment of the fund shall be credited to the fund.

D. The fund may be divided into accounts as deemed necessary by the department, one of which shall be the bond account required pursuant to Subsection F of this section.

E. Money in the fund is appropriated to the council for expenditure in fiscal year 2008 or any subsequent fiscal year for use to implement the provisions of and to administer the Native American Health Care Improvement Act. Money in the fund may be disbursed to:

(1) fund grants authorized by the council; or (2) provide revenue to repay bonds issued by the New Mexico finance authority for projects authorized by the council.

F. If the council authorizes capital outlay projects:

(1) the secretary shall enter into an agreement with the New Mexico finance authority to authorize the authority to issue Native American health care capital project bonds in an amount needed to implement the capital projects authorized by the council; and

(2) the secretary shall create an account in the fund, to be referred to as the "bond account" and:

(a) deposit in the bond account the money to pay for the issuance of the bonds and pay principal, interest, premiums and other expenses or obligations on the bonds;

(b) money in the bond account shall be pledged irrevocably to the repayment of Native American health care capital project bonds issued by the New Mexico finance authority;

(c) money from the bond account shall be transferred to the New Mexico finance authority Native American health care account on July 1 of each fiscal year or immediately thereafter, in an amount estimated by the New Mexico finance authority to cover the repayment costs of the Native American health care capital project bonds for the new fiscal year; and

(d) interest on the bond account created in this subsection shall be deposited to the credit of the bond account and shall not revert to the fund until the secretary receives certification from the New Mexico finance authority that the obligations for the Native American health care capital project bonds issued pursuant to authorization of the council have been fully discharged.

G. Money in the fund may be used for administration of the fund, including the costs of staffing the council, implementing the Native American Health Care Improvement Act and paying related per diem and mileage, in an amount equal to no more than ten percent of the fund, not to exceed two hundred fifty thousand dollars ($250,000) in a fiscal year.

H. Expenditures shall be made from the fund on warrants issued by the secretary of finance and administration on vouchers signed by the secretary of health.

I. Balances in the fund shall not revert to the general fund at the end of any fiscal year.

Section 8. [NEW MATERIAL] COUNCIL GRANTS.--

A. The council shall prioritize proposals submitted pursuant to the Native American Health Care Improvement Act. The council shall authorize an amount of funding for grants in the council's priority list. The secretary shall enter into contracts with grantees and distribute money from the fund for proposals approved and funding authorized by the council.

B. The council shall not approve a proposal or authorize funding for a proposal unless the proposal fits within the action plan and strategic plan of the council and the applicant demonstrates knowledge of the current capacity to provide health care in the community in which the applicant will be working, the need for the project and the anticipated value of the outcome of the project in regard to the goals of the Native American Health Care Improvement Act.

C. A grant may be revised or terminated at the request of the council through the department if the grant as implemented is not achieving the agreed-upon goals.

Section 9. [NEW MATERIAL] POWERS AND DUTIES OF THE DEPUTY SECRETARY FOR NATIVE AMERICAN HEALTH IMPROVEMENT.--The deputy secretary for Native American health improvement shall:

A. direct the staffing of the council;

B. review and evaluate proposals submitted to the council and recommend either approval, modification or rejection of a proposal;

C. be authorized by the secretary to issue contracts or joint powers agreements with tribal governments pursuant to the Joint Powers Agreements Act on behalf of the council for grants approved and authorized by the council;

D. oversee the grants awarded by the council; gather information necessary to evaluate the effectiveness of programs and services funded by council grants; report the findings to the council on a monthly basis; and recommend revisions or termination of proposals as deemed necessary to achieve the objectives of the Native American Health Care Improvement Act;

E. by July 31 of each year, provide the council with an assessment of the progress or shortcomings of grants authorized by the council in the previous fiscal year;

F. when requested by a prospective applicant, provide:

(1) technical assistance to assess the needs and develop a health care improvement plan for a tribe or agency;

(2) training to assist in the development of proposals to improve the health of or the delivery of health care to Native Americans of the applicant; or

(3) technical assistance to implement a council-authorized proposal to help the grantee successfully complete the project or to revise the project to redirect the funding in a manner that leads to the successful completion of the project;

G. recommend best practices identified and successful programs that can be duplicated in other Native American communities to the council; and

H. propose rules for the council to adopt to implement the Native American Health Care Improvement Act that are necessary to carry out the purposes of that act.

Section 10. A new section of the New Mexico Finance Authority Act is enacted to read:

"[NEW MATERIAL] NATIVE AMERICAN HEALTH CARE CAPITAL PROJECT BONDS.--

A. The authority may issue and sell bonds, which may be referred to as "Native American health care capital project bonds", in compliance with the New Mexico Finance Authority Act for a term not exceeding fifteen years in an amount not exceeding ten million dollars ($10,000,000) for the purpose of planning, designing, constructing, equipping, furnishing and landscaping health care facilities authorized by the Native American health council pursuant to the Native American Health Care Improvement Act.

B. The authority may issue and sell Native American health care capital project bonds authorized by this section when the secretary of health certifies the need for issuance of the bonds. The net proceeds from the sale of the bonds are appropriated to the authority for distribution in grants to the projects authorized by the Native American health council for the purposes described in Subsection A of this section and authorized by that council.

C. On an annual basis, on July 1 or immediately thereafter, the secretary of health shall distribute to the Native American health care account of the authority from the bond account of the Native American health care improvement fund the amount necessary to pay the principal, interest, premiums and other expenses or obligations related to the Native American health care capital project bonds required to be paid in the fiscal year. Money in the bond account of the Native American health care improvement fund is irrevocably pledged to the payment of obligations, including principal, interest, premiums and other expenses of Native American health care capital project bonds.

D. Upon payment of all principal, interest and other expenses or obligations related to the bonds, the authority shall certify to the secretary of health that all obligations for the Native American health care capital project bonds issued pursuant to this section have been fully discharged.

E. The authority may additionally secure the Native American health care capital project bonds issued pursuant to this section by a pledge of money in the public project revolving fund with a lien priority on the money in the public project revolving fund as determined by the authority."

Section 11. A new section of the New Mexico Finance Authority Act is enacted to read:

"[NEW MATERIAL] NATIVE AMERICAN HEALTH CARE ACCOUNT.--

A. The "Native American health care account" is created as a separate account within the authority for use only as provided in this section.

B. All distributions from the bond account of the Native American health care improvement fund made by the secretary of health to the authority for payment of principal, interest, premiums or other expenses or obligations on Native American health care capital project bonds shall be deposited in the Native American health care account of the authority.

C. Amounts deposited in the Native American health care account shall be pledged irrevocably for the payment of the principal, interest, premiums and expenses or other obligations on Native American health care capital project bonds issued by the authority to plan, design, construct, equip, furnish or landscape health care facilities authorized by the Native American health council pursuant to the Native American Health Care Improvement Act.

D. The authority shall project annually by June 30 the amount of revenue required to pay the principal, interest, premiums or expenses or other obligations due in the upcoming fiscal year on Native American health care capital project bonds issued by the authority. The projection shall be submitted to the secretary of health, who shall transfer the amount projected by the authority minus any unencumbered balance remaining in the authority's Native American health care account that remains available for expenditure in the upcoming fiscal year for the purposes set forth in this section to the authority for deposit in the Native American health care account."

Section 12. Section 9-2A-1 NMSA 1978 (being Laws 1992, Chapter 57, Section 1) is amended to read:

"9-2A-1. SHORT TITLE.--[Sections 1 through 16 of this act] Chapter 9, Article 2A NMSA 1978 may be cited as the "Children, Youth and Families Department Act"."

Section 13. A new section of the Children, Youth and Families Department Act, Section 9-2A-7.1 NMSA 1978, is enacted to read:

"9-2A-7.1. [NEW MATERIAL] SECRETARY'S DUTY--SPECIFIC REQUIREMENT--TRIBAL LIAISON.--

A. The secretary shall employ in a full-time exempt position a tribal liaison, who reports directly to the secretary, to:

(1) provide a contact person to aid in communication between the department and tribal communities or Native Americans living in urban environments;

(2) provide training to the staff of the department in protocol, culturally competent behaviors and cultural history to assist the department in providing effective service to tribes;

(3) work with the tribes, tribal members, Native Americans living in urban environments and Native Americans representing urban Native American populations to resolve issues that arise with actions or programs of the department;

(5) suggest and implement with the secretary's approval, efforts to improve the manner and outcome of interactions with tribes and Native American populations living in urban environments; and

(6) perform other duties as assigned by the secretary.

B. As used in this section:

(1) "tribal" means of or belonging to a tribe; and

(2) "tribe" means a federally recognized Indian nation, tribe or pueblo located wholly or partly in New Mexico."

Section 14. A new section of the Department of Health Act, Section 9-7-6.7 NMSA 1978, is enacted to read:

"9-7-6.7. [NEW MATERIAL] SECRETARY'S DUTY--SPECIFIC REQUIREMENTS--DEPUTY SECRETARY FOR NATIVE AMERICAN HEALTH IMPROVEMENT--TRIBAL LIAISON.--

A. The secretary shall employ in a full-time exempt position a deputy secretary of Native American health improvement to administer and implement the Native American Health Care Improvement Act, direct the staff provided by the department for the Native American health council and perform other duties as assigned by the secretary.

B. The secretary shall employ in a full-time exempt position a tribal liaison, who reports directly to the secretary, to:

(1) provide a contact person to aid in communication between the department and tribal communities or Native Americans living in urban environments;

(2) provide training to the staff of the department in protocol, culturally competent behaviors and cultural history to assist the department in providing effective service to tribes;

(5) suggest and implement with the secretary's approval, efforts to improve the manner and outcome of interactions with tribes and Native American populations living in urban environments; and

(6) perform other duties as assigned by the secretary.

C. As used in this section:

(1) "tribal" means of or belonging to a tribe; and

(2) "tribe" means a federally recognized Indian nation, tribe or pueblo located wholly or partly in New Mexico."

Section 15. Section 9-8-1 NMSA 1978 (being Laws 1977, Chapter 252, Section 1) is amended to read:

"9-8-1. SHORT TITLE.--[Sections 1 through 14 of this act] Chapter 9, Article 8 NMSA 1978 may be cited as the "Human Services Department Act"."

Section 16. A new section of the Human Services Department Act, Section 9-8-6.1 NMSA 1978, is enacted to read:

"9-8-6.1. [NEW MATERIAL] SECRETARY'S DUTY--SPECIFIC REQUIREMENT--TRIBAL LIAISON.--

A. The secretary shall employ in a full-time exempt position a tribal liaison, who reports directly to the secretary, to:

(1) provide a contact person to aid in communication between the department and tribal communities or Native Americans living in urban environments;

(2) provide training to the staff of the department in protocol, culturally competent behaviors and cultural history to assist the department in providing effective service to tribes;

(4) interact with other state agency tribal liaisons and attend meetings of legislative committees that are discussing issues that involve both the department and tribal or urban Native American communities in the state; (5) suggest and implement with the secretary's approval, efforts to improve the manner and outcome of interactions with tribes and Native American populations living in urban environments; and

(6) perform other duties as assigned by the secretary.

B. As used in this section:

(1) "tribal" means of or belonging to a tribe; and

(2) "tribe" means a federally recognized Indian nation, tribe or pueblo located wholly or partly in New Mexico."

Section 17. Section 9-23-1 NMSA 1978 (being Laws 2004, Chapter 23, Section 1) is amended to read:

"9-23-1. SHORT TITLE.--[Sections 1 through 11 of this act] Chapter 9, Article 23 NMSA 1978 may be cited as the "Aging and Long-Term Services Department Act"."

Section 18. A new section of the Aging and Long-Term Services Department Act, Section 9-23-6.1 NMSA 1978, is enacted to read:

"9-23-6.1. [NEW MATERIAL] SECRETARY'S DUTY--SPECIFIC REQUIREMENT--TRIBAL LIAISON.--

A. The secretary shall employ in a full-time exempt position a tribal liaison, who reports directly to the secretary, to:

(1) provide a contact person to aid in communication between the department and tribal communities or Native Americans living in urban environments;

(2) provide training to the staff of the department in protocol, culturally competent behaviors and cultural history to assist the department in providing effective service to tribes;

(5) suggest and implement with the secretary's approval, efforts to improve the manner and outcome of interactions with tribes and Native American populations living in urban environments; and

(6) perform other duties as assigned by the secretary.

B. As used in this section:

(1) "tribal" means of or belonging to a tribe; and

(2) "tribe" means a federally recognized Indian nation, tribe or pueblo located wholly or partly in New Mexico."

Section 19. APPROPRIATION.--

A. Ten million dollars ($10,000,000) is appropriated from the general fund to the Native American health care improvement fund for expenditure in fiscal year 2008 and subsequent fiscal years for the following purposes:

(1) two million two hundred thousand dollars ($2,200,000) to support the development of local plans for improvement of the delivery of health care to Native American people and to improve the health of Native American people and their communities;

(2) five million dollars ($5,000,000) to support, supplement or expand the existing components of the health care system providing services to Native American people to improve delivery of health care to the Native American population;

(3) five hundred thousand dollars ($500,000) to expand the scope of investigation and research of the center for Native American health of the health sciences center of the school of medicine of the university of New Mexico;

(4) six hundred thousand dollars ($600,000) for recruitment and retention of students training for careers in medicine or ancillary fields to become medical practitioners or medical researchers;

(5) five hundred thousand dollars ($500,000) for research and epidemiological studies;

(6) four hundred thousand dollars ($400,000) for technical assistance and outreach to implement the components of the Native American Health Care Improvement Act;

(7) four hundred thousand dollars ($400,000) for information systems and technology support for tribal health care delivery systems; and

(8) four hundred thousand dollars ($400,000) to complete an assessment of unmet behavioral health needs in tribal communities, including assessing the availability of and need for juvenile and adult behavioral health treatment facilities.

B. Any unexpended or unencumbered balance remaining at the end of a fiscal year shall not revert to the general fund but shall remain in the Native American health care improvement fund for future expenditure pursuant to the Native American Health Care Improvement Act.

Section 20. EFFECTIVE DATE.--The effective date of the provisions of this act is July 1, 2007.

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