HOUSE BILL 70

57th legislature - STATE OF NEW MEXICO - first session, 2025

INTRODUCED BY

Tara L. Lujan

 

 

 

 

 

AN ACT

RELATING TO HEALTH CARE; ENACTING THE BEHAVIORAL HEALTH MEDICAID WAIVER ACT; MAKING AN APPROPRIATION; DECLARING AN EMERGENCY.

 

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

     SECTION 1. [NEW MATERIAL] SHORT TITLE.--This act may be cited as the "Behavioral Health Medicaid Waiver Act".

     SECTION 2. [NEW MATERIAL] DEFINITIONS.--As used in the Behavioral Health Medicaid Waiver Act:

          A. "behavioral health disability" means serious mental illness, serious emotional disturbance, substance use disorder or brain injury whenever that condition:

                (1) substantially impairs a person's ability to manage the person's own affairs; or

                (2) makes a person eligible to receive disability benefits from New Mexico or the federal government;

          B. "brain injury" means an injury to the brain of traumatic or acquired origin, including an open or closed head injury, caused by:

                (1) an insult to the brain from an outside physical force;

                (2) anoxia;

                (3) an electrical shock;

                (4) shaken baby syndrome;

                (5) a toxic or chemical substance;

                (6) a near-drowning;

                (7) an infection;

                (8) a tumor;

                (9) a vascular lesion; or

                (10) an event that results in either temporary or permanent, partial or total impairment in one or more areas of the brain that results in total or partial functional disability, including:

                     (a) cognition;

                     (b) language;

                     (c) memory;

                     (d) attention;

                     (e) reasoning;

                     (f) abstract thinking;

                     (g) judgment;

                     (h) problem solving;

                     (i) sensory perception and motor abilities;

                     (j) psychosocial behavior;

                     (k) physical functions;

                     (l) information processing; or

                     (m) speech;

          C. "serious emotional disturbance" means a diagnosable mental, behavioral or emotional disorder in a person under the age of eighteen years and of sufficient duration to meet diagnostic criteria that results in functional impairment that substantially interferes with or limits the person's role or functioning in family, school or community activities;

          D. "serious mental illness" means a diagnosable mental, behavioral or emotional disorder in a person eighteen years of age or older of sufficient duration to meet diagnostic criteria that results in functional impairment that substantially interferes with or limits one or more major life activities; and

          E. "substance use disorder" means dependence on or abuse of alcohol, illicit drugs or psychotherapeutics, including prescription pain relievers, sedatives, tranquilizers or stimulants, in the past twelve months based on assessments of individual diagnostic criteria from the current edition of the Diagnostic and Statistical Manual of Mental Disorders published by the American psychiatric association.

     SECTION 3. [NEW MATERIAL] HEALTH CARE AUTHORITY DUTIES--PERSONS WITH BEHAVIORAL HEALTH DISABILITIES.--

          A. Subject to the availability of appropriations provided expressly for this purpose, the health care authority shall:

                (1) acquire, provide or coordinate support and services for persons with behavioral health disabilities;

                (2) enter into contracts and provider agreements with agencies and persons capable of providing support and services to persons with behavioral health disabilities; and

                (3) establish advisory councils and task forces as necessary to guide the development of and to review the operation of support and services to persons with behavioral health disabilities.

          B. Support and services shall be provided by the health care authority based on individual support and service plans developed by an interdisciplinary team. The team is responsible for collectively evaluating a person's needs and developing an individual support and service plan to meet the needs.

          C. The health care authority shall:

                (1) solicit the involvement of persons with behavioral health disabilities and their family members, providers, parents, professional organizations and other governmental organizations prior to the adoption or revision of rules concerning the provision of support, services, standards or funding systems; provided that participants shall be selected in a manner that reflects geographical, cultural, organizational and professional representation across New Mexico; and

                (2) develop rules, including policies and procedures that, to the extent possible, promote uniformity in reimbursement and quality assurance systems regardless of the source of funding.

     SECTION 4. [NEW MATERIAL] TEMPORARY PROVISION--DUTIES OF HEALTH CARE AUTHORITY--MEDICAID WAIVER PROGRAM.--

          A. The health care authority shall immediately conduct monthly meetings with persons with behavioral health disabilities and their family members, providers of behavioral health services, the university of New Mexico, advocates for persons with behavioral health disabilities and county and municipal officials who are serving persons with behavioral health disabilities to determine the best way to apply to the federal centers for medicare and medicaid services for authorization to operate a medicaid waiver program for persons with behavioral health disabilities. The meetings shall continue until the health care authority has submitted an application to the federal centers for medicare and medicaid services for authorization to operate a medicaid waiver program for residents of New Mexico with behavioral health disabilities.

          B. The health care authority shall retain a consulting entity to assist the health care authority in the development of an application to the federal centers for medicare and medicaid services for authorization to operate a medicaid waiver program for persons with behavioral health disabilities.

          C. No later than December 31, 2025, the health care authority shall submit an application to the federal centers for medicare and medicaid services for authorization to operate a medicaid waiver program for persons with behavioral health disabilities, seeking authorization to operate a medicaid waiver program for persons with behavioral health disabilities that is comparable to New Mexico's home and community-based medicaid waiver programs for persons with developmental disabilities.

     SECTION 5. APPROPRIATION.--One million one hundred thousand dollars ($1,100,000) is appropriated from the general fund to the health care authority for expenditure in fiscal years 2026 and 2027 to retain a qualified consultant to guide the health care authority in the development of an application to the federal government for the creation of a behavioral health medicaid waiver program and to hire four full-time employees to work exclusively to develop and submit the application for a medicaid waiver program. Any unexpended or unencumbered balance remaining at the end of fiscal year 2027 shall revert to the general fund.

     SECTION 6. EMERGENCY.--It is necessary for the public peace, health and safety that this act take effect immediately.

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