SENATE BILL 172

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

INTRODUCED BY

Linda M. Trujillo and Cindy Nava and D. Wonda Johnson

and Janelle Anyanonu

 

 

 

 

AN ACT

RELATING TO HEALTH CARE; INCREASING THE STATE'S HEALTH CARE WORKFORCE BY ENACTING THE IMMIGRANT HEALTH CARE WORKFORCE DEVELOPMENT ACT; PROVIDING FOR AN IMMIGRANT HEALTH CARE PROFESSIONAL ACCELERATION PROGRAM; PROVIDING FOR AN IMMIGRANT PRIMARY CARE PHYSICIAN READINESS PATHWAY; PROVIDING FOR AN IMMIGRANT PRIMARY CARE RESIDENCY GRANT PROGRAM; CREATING THE IMMIGRANT HEALTH CARE WORKFORCE DEVELOPMENT FUND; CREATING THE IMMIGRANT HEALTH CARE WORKFORCE ADVISORY GROUP; AMENDING DEFINITIONS IN THE MEDICAL PRACTICE ACT; MAKING AN APPROPRIATION.

 

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 "Immigrant Health Care Workforce Development Act".

     SECTION 2. [NEW MATERIAL] DEFINITIONS.--As used in the Immigrant Health Care Workforce Development Act:

          A. "accrediting council" means the accreditation council for graduate medical education;

          B. "department" means the workforce solutions department; 

          C. "immigrant" means an individual who was born outside of the United States, who resides permanently in the United States and who is authorized to work in the United States under federal laws and regulations;

          D. "participant" means an underemployed immigrant health care worker who is participating in the immigrant health care professional acceleration program;

          E. "primary care physician" means a physician licensed in New Mexico to practice general family medicine, general internal medicine, obstetrics and gynecology or general pediatric medicine;

          F. "prior foreign health care experience" means training or experience in a broadly recognized health care field that is attained outside of the United States and Canada, including at least twelve months of educational or vocational training or at least twenty-four months of clinical work experience;

          G. "qualified international medical graduate" means a physician who has a medical degree or qualification from a medical school located outside of the United States and Canada that is recognized by the world health organization or the world directory of medical schools; 

          H. "secretary" means the secretary of workforce solutions;

          I. "underemployed immigrant health care worker" means an individual who is an immigrant and who has prior foreign health care education or experience, is unemployed or is not working in health care or is working in health care in a position with a scope of practice below the individual's highest level of foreign health care experience or licensure; and

          J. "underserved community" means a New Mexico area or population included in the list of designated primary medical care health professional shortage areas, medically underserved areas or medically underserved populations maintained and updated by the United States department of health and human services or by any applicable state equivalent thereof.

     SECTION 3. [NEW MATERIAL] IMMIGRANT HEALTH CARE PROFESSIONAL ACCELERATION PROGRAM--PARTICIPANT SUPPORT--PRIMARY CARE PHYSICIAN READINESS PATHWAY.--

          A. The department shall establish and maintain an immigrant health care professional acceleration program to support underemployed immigrant health care workers. The program shall provide participants:

                (1) educational and career navigation, including:

                     (a) information on training and licensing requirements; 

                     (b) guidance in determining the pathway best suited for a participant based on the participant's skills, experience, resources and interests;

                     (c) information and guidance regarding funding sources for training and education; and

                     (d) information regarding practice areas for careers as physicians, nurses, physician assistants or other health care professionals;

                (2) training and funding for that training to support and facilitate participants who identify a need to acquire medical English proficiency;

                (3) support with integration into the New Mexico community and labor force, including peer group support and professional associations;

                (4) training and funding for that training for participants to become familiar with using medical information technologies, including acquiring and updating contemporary computer skills and the use of electronic health record technologies;

                (5) training and funding for that training to improve participants' knowledge, familiarity and skills in the use of health care and health insurance systems used by health care professionals and health care-related entities in New Mexico and the United States;

                (6) support and guidance to acquire, develop and expand applicable foundational skills the department may identify as necessary or appropriate;

                (7) financial support, contingent on the availability of funds, including stipends and reimbursements for travel costs, test fees or test preparation costs and other costs or expenses identified by the department as critical to participants' successful completion of the program; and

                (8) support to become credentialed, certified, licensed or registered by the appropriate state licensing authorities applicable to each participant's chosen health care career, including assistance with preparation for required licensing examinations and financial assistance for related fees.

          B. In administering the immigrant health care professional acceleration program, the department shall partner with a licensed health care provider in New Mexico for the development and operation of an immigrant primary care physician readiness pathway for qualified immigrant international medical graduates seeking to become licensed primary care physicians in New Mexico. The pathway shall be designed to:

                (1) prepare participants to enter a United States residency program in a primary care specialty in a clinical readiness program to last no less than six months and not to exceed twelve months;

                (2) prepare participants to take the Comprehensive Osteopathic Medical Licensing Examination of the United States, United States Medical Licensing Examination or other examinations necessary upon completion of a residency program to obtain a license to practice as a primary care physician in New Mexico; and

                (3) provide stipends or other support for participants while the participants are not employed full-time and for a period of time determined as necessary and reasonable by the department. 

     SECTION 4. [NEW MATERIAL] IMMIGRANT HEALTH CARE PROFESSIONAL ACCELERATION PROGRAM--ELIGIBILITY--UNDERSERVED COMMUNITIES RULES--PRIMARY CARE PHYSICIAN--READINESS PATHWAY--ELIGIBILITY.--

          A. To be eligible to participate in the immigrant health care professional acceleration program, an underemployed immigrant health care worker shall:

                (1) not be present in the United States on a J1 visa following acceptance into a United States medical residency or fellowship program;

                (2) not be present in the United States on a non-immigrant employment-based visa;

                (3) have prior foreign health care experience;

                (4) be a New Mexico resident during program participation; and

                (5) commit to living in New Mexico and working in one of New Mexico's underserved communities post-licensure for a period of time that is the longer of:

                     (a) at least one year; or

                     (b) a period of time commensurate with the level of financial support received by the participant, not to exceed three years.

          B. The department shall promulgate rules and methods to identify and evaluate rural or underserved communities where program participants can live and work while providing primary care medical services to those communities.

          C. To be eligible to participate in the immigrant primary care physician readiness pathway, a qualified immigrant international medical graduate shall:

                (1) receive a certificate of acceleration program completion based on that individual's skills, participation, experience and other prerequisites set by the department, as demonstrated during the individual's participation in the immigrant health care professional acceleration program;

                (2) have attained educational commission for foreign medical graduates certification, a substantially similar certification or a generally recognized and accepted alternative evaluation of medical training as approved by the department;

                (3) have completed a post-graduate training program in a country outside of the United States and Canada that is substantially similar to a United States residency program accredited by the accrediting council;

                (4) have been licensed to practice medicine in a country other than the United States or Canada for at least three years; and

                (5) commit to practicing as a primary care physician for three years in an underserved community in New Mexico post-licensure, not including time spent participating in a New Mexico residency program, which service shall be counted as served concurrently with any other commitment for service in an underserved community in New Mexico accrued during participation in the immigrant health care professional acceleration program.

     SECTION 5. [NEW MATERIAL] IMMIGRANT HEALTH CARE PROFESSIONAL ACCELERATION PROGRAM--IMMIGRANT PRIMARY CARE PHYSICIAN READINESS PATHWAY--PARTICIPATION SELECTION CRITERIA.--The department shall establish criteria for selection of individuals to participate in the immigrant health care professional acceleration program and the immigrant primary care physician readiness pathway. In addition to meeting the educational and professional experience requirements, other participant eligibility criteria for selection shall include an underemployed immigrant health care worker's:

          A. demonstrated interest in serving in one of New Mexico's underserved communities; 

          B. personal connections or ties to New Mexico;

          C. experience, skills or cultural competencies required in New Mexico's health care workforce; and

          D. education, experience or skills in areas of practice that are in-demand statewide or in a county or region within New Mexico, according to available labor market information.

     SECTION 6. [NEW MATERIAL] IMMIGRANT PRIMARY CARE RESIDENCY GRANT.--

          A. The department, in partnership with department-approved health care education programs, shall establish and maintain an immigrant primary care residency grant to support primary care residency positions in New Mexico designated for eligible qualified immigrant international medical graduates.

          B. To be eligible to receive grant funding, a health care education program applicant shall:

                (1) be a medical education program in a program approved by the accrediting council as provided in the Immigrant Health Care Workforce Development Act;

                (2) be located in New Mexico; and

                (3) identify each qualified immigrant international medical graduate designated to fill a funded primary care residency position.

          C. As a condition of grant approval, each grant recipient shall agree to the following:

                (1) a grant awarded pursuant to this section shall not supplant an existing local, state, federal or private funding support, if any, of residency positions;

                (2) a grant recipient shall not reduce its residency program's approved residency quota, measured as an average of its three prior-year primary care residency quotas, not including other residency positions funded by the immigrant primary care residency grant;

                (3) a grant recipient shall not in any way replace its residency program's primary care residency positions with designated qualified immigrant international medical graduate residency positions;

                (4) a grant recipient's program shall not violate the Human Rights Act;

                (5) a grant recipient's program shall not establish criteria for the residencies that exceed reasonable requirements or expectations for other residency applicants in the same or a substantially similar primary care residency program;

                (6) a grant recipient's program shall not create undue or burdensome barriers for otherwise eligible applicants to be eligible for a residency position; and

                (7) a grant recipient shall fill the funded residency positions with participants who have successfully completed the primary care physician readiness pathway; provided, however, that if there are fewer individuals who have successfully completed the immigrant primary care physician readiness pathway than available funding, residency grant recipient managers may apply for a waiver to fill the funded residency position with a qualified immigrant international medical graduate who meets the eligibility criteria for the immigrant primary care physician readiness program. Waivers shall be issued at the discretion of the secretary.

          D. Priority shall be given to residency grant applicants serving underserved communities.

     SECTION 7. [NEW MATERIAL] IMMIGRANT HEALTH CARE WORKFORCE DEVELOPMENT FUND CREATED.--The "immigrant health care workforce development fund" is created as a nonreverting fund in the state treasury. The fund consists of appropriations, gifts, grants and donations to the fund. Money in the fund is subject to appropriation by the legislature to the department to implement and administer the provisions of the Immigrant Healthcare Workforce Development Act. Disbursements from the fund shall be made by vouchers signed by the secretary or the secretary's designee upon warrants signed by the secretary of finance and administration.

     SECTION 8. [NEW MATERIAL] ADVISORY COMMITTEE.--

          A. The secretary shall appoint an "immigrant health care workforce advisory committee" composed of no more than fifteen individuals representing state agencies, medical professional associations, community-based organizations, graduate medical education providers and other relevant stakeholders, including at least one qualified immigrant international medical graduate and at least one internationally educated nurse, both of whom shall have been licensed health care providers in and residents of New Mexico.

          B. Upon the request of the secretary, the immigrant health care workforce advisory committee shall:

                (1) advise the department on developing streamlined pathways for underemployed immigrant health care workers to provide health care services in New Mexico's workforce;

                (2) collaborate with appropriate state regulatory and licensing agencies and other stakeholders toward that goal; and

                (3) assist and advise the department regarding matters in furtherance of the purposes of the Immigrant Health Care Workforce Development Act.

          C. Public members of the immigrant health care workforce advisory committee are entitled to per diem and mileage pursuant to the Per Diem and Mileage Act and shall receive no other compensation, perquisite or allowance.

          D. The department shall provide reports and recommendations derived from the work of the immigrant health care workforce advisory committee to the legislative finance committee and other legislative committees as deemed appropriate by the secretary.

     SECTION 9. [NEW MATERIAL] RULES.--The department shall adopt rules in accordance with the State Rules Act and as necessary to carry out the provisions of the Immigrant Health Care Workforce Development Act.

     SECTION 10. Section 61-6-6 NMSA 1978 (being Laws 1973, Chapter 361, Section 1, as amended) is amended to read:

     "61-6-6. DEFINITIONS.--As used in the Medical Practice Act:

          A. "approved postgraduate training program for physicians" means a program approved by the accreditation council for graduate medical education, the American osteopathic association or other board-approved program;

          B. "board" means the New Mexico medical board;

          C. "collaboration" means the process by which a licensed physician and a physician assistant jointly contribute to the health care and medical treatment of patients; provided that:

                (1) each collaborator performs actions that the collaborator is licensed or otherwise authorized to perform; and

                (2) collaboration shall not be construed to require the physical presence of the licensed physician at the time and place services are rendered;

          D. "licensed physician" means a medical or osteopathic physician licensed under the Medical Practice Act to practice medicine in New Mexico;

          E. "licensee" or "health care practitioner" means a medical physician, osteopathic physician, physician assistant, polysomnographic technologist, anesthesiologist assistant, naturopathic doctor, podiatric physician or naprapath licensed by the board to practice in New Mexico;

          F. "medical college or school in good standing" for medical physicians means a board-approved medical college or school that has as high a standard as that required by the association of American medical colleges and the council on medical education of the American medical association; and for osteopathic physicians means a college of osteopathic medicine accredited by the commission of osteopathic college accreditation;

          G. "medical student" means a student enrolled in a board-approved medical college or school in good standing;

          H. "physician assistant" means a health care practitioner who is licensed by the board to practice as a physician assistant and who provides services to patients with the supervision of or in collaboration with a licensed physician as set forth in rules promulgated by the board;

          I. "qualified international medical graduate" means a physician who has a medical degree or qualification from a medical school located outside the United States and Canada recognized by the world health organization or the world directory of medical schools as provided in the Immigrant Health Care Workforce Development Act;

          [I.] J. "resident" means a graduate of a medical college or school in good standing who is in training in a board-approved and accredited residency training program in a hospital or facility affiliated with an approved hospital and who has been appointed to the position of "resident" or "fellow" for the purpose of postgraduate medical training;

          [J.] K. "the practice of medicine" consists of:

                (1) advertising, holding out to the public or representing in any manner that one is authorized to practice medicine or to practice health care that is under the authority of the board in this state;

                (2) offering or undertaking to administer, dispense or prescribe a drug or medicine for the use of another person, except as authorized pursuant to a professional or occupational licensing statute set forth in Chapter 61 NMSA 1978;

                (3) offering or undertaking to give or administer, dispense or prescribe a drug or medicine for the use of another person, except as directed by a licensed physician;

                (4) offering or undertaking to perform an operation or procedure upon a person;

                (5) offering or undertaking to diagnose, correct or treat in any manner or by any means, methods, devices or instrumentalities any disease, illness, pain, wound, fracture, infirmity, deformity, defect or abnormal physical or mental condition of a person;

                (6) offering medical peer review, utilization review or diagnostic service of any kind that directly influences patient care, except as authorized pursuant to a professional or occupational licensing statute set forth in Chapter 61 NMSA 1978; or

                (7) acting as the representative or agent of a person in doing any of the things listed in this subsection;

          [K.] L. "the practice of medicine across state lines" means:

                (1) the rendering of a written or otherwise documented medical opinion concerning diagnosis or treatment of a patient within this state by a physician located outside this state as a result of transmission of individual patient data by electronic, telephonic or other means from within this state to the physician or the physician's agent; or

                (2) the rendering of treatment to a patient within this state by a physician located outside this state as a result of transmission of individual patient data by electronic, telephonic or other means from within this state to the physician or the physician's agent;

          [L.] M. "sexual contact" means touching the primary genital area, groin, anus, buttocks or breast of a patient or allowing a patient to touch another's primary genital area, groin, anus, buttocks or breast in a manner that is commonly recognized as outside the scope of acceptable medical or health care practice;

          [M.] N. "sexual penetration" means sexual intercourse, cunnilingus, fellatio or anal intercourse, whether or not there is any emission, or introducing any object into the genital or anal openings of another in a manner that is commonly recognized as outside the scope of acceptable medical or health care practice; [and]

          O. "underserved community" means a New Mexico area or population included in the list of designated primary medical care health professional shortage areas, medically underserved areas or medically underserved populations maintained and updated by the United States department of health and human services or any state equivalent thereof; and

          [N.] P. "United States" means the fifty states, its territories and possessions and the District of Columbia."

     SECTION 11. Section 61-6-11 NMSA 1978 (being Laws 1923, Chapter 44, Section 3, as amended) is amended to read:

     "61-6-11. PHYSICIAN LICENSURE.--

          A. The board may consider for licensure a person who is of good moral character, is a graduate of an accredited United States or Canadian medical or osteopathic medical school, has passed an examination approved by the board and has completed two years of an approved postgraduate training program for physicians.

          B. An applicant who has not completed two years of an approved postgraduate training program for physicians, but who otherwise meets all other licensing requirements, may present evidence to the board of the applicant's other professional experience for consideration by the board in lieu of the approved postgraduate training program. The board shall, in its sole discretion, determine if the professional experience is substantially equivalent to the required approved postgraduate training program for physicians.

          C. A graduate of a board-approved medical or osteopathic medical school located outside the United States or Canada may be granted a license to practice medicine in New Mexico, provided the applicant presents evidence to the board that the applicant is a person of good moral character and provided that the applicant presents satisfactory evidence to the board that the applicant has successfully passed an examination as required by the board and has successfully completed two years of postgraduate medical training in an approved postgraduate training program for physicians. A graduate of a medical school located outside the United States who successfully completes at least two years of an approved postgraduate training program for physicians at or affiliated with an institution located in New Mexico prior to December 30, 2007 and who meets the other requirements of this section may also be granted a license to practice medicine.

          D. The board may issue to an applicant who is a qualified international medical graduate a provisional license to practice medicine valid for a period not to exceed two years if the applicant submits evidence acceptable to the board that the applicant:

                (1) has graduated from a legally chartered medical school outside of the United States and Canada recognized by the world health organization or the world directory of medical schools;

                (2) has been licensed or otherwise authorized to practice medicine in a country other than the United States and has not been out of practice for more than two years;

                (3) has a valid certificate issued by the educational commission for foreign medical graduates or other credential evaluation service approved by the board; provided, however, that the board may waive certification at the board's discretion if the applicant is unable to obtain the required documentation from a noncooperative country;

                (4) has achieved a passing score on both step 1 and step 2 clinical knowledge of the United States medical licensing examination;

                (5) has entered into an agreement with a medical care facility that provides an assessment and evaluation program designed to develop, assess and evaluate the physician's nonclinical skills and familiarity with standards appropriate for medical practice in New Mexico according to criteria developed or approved by the board, which shall promulgate rules regarding these standards;

                (6) has an offer of full-time employment from the medical care facility identified in Paragraph (5) of this subsection after the board issues a license pursuant to this subsection; and

                (7) has satisfied any other criteria that the board may require for issuance of a provisional license pursuant to this subsection.

          E. An individual who successfully obtains a license pursuant to Subsection D of this section and practices under that license until the license's expiration shall be eligible to apply for a renewable two-year restricted license to practice medicine in an underserved community in New Mexico. The board may issue a renewable license to an applicant if the applicant submits evidence acceptable to the board that the applicant:

                (1) has successfully completed the participating facility's assessment and evaluation program required pursuant to Subsection D of this section;

                (2) has achieved a passing score on step 3 of the United States medical licensing examination;

                (3) has an offer of full-time employment from a health care facility, including a public hospital, a for- profit or nonprofit private hospital, a general or special hospital, an outpatient facility, a freestanding birth center, a nursing home, an intermediate care facility, an assisted living facility or other health care facility at which medical care is provided by state-licensed medical care practitioners, in an underserved community in New Mexico; and

                (4) has no disciplinary actions or pending investigations related to the applicant's practice under the provisional license issued pursuant to Subsection D of this section.

          F. After at least two years of practice under a renewable two-year restricted license issued pursuant to Subsection E of this section resulting in no disciplinary actions or pending investigations, the board shall grant a license to practice medicine to an internationally trained physician who meets the other requirements of this section.

[D.] G. All applicants for licensure may be

required to appear personally before the board or a designated agent for an interview.

          [E.] H. An applicant for licensure by examination shall not be granted a license if the applicant has taken the examination in two or more steps and has failed to successfully pass the final step within seven years of the date that the first step was passed. An applicant for licensure who holds a medical or osteopathic doctor degree and a doctoral degree in a medically related field must successfully complete the entire examination series within ten years from the date the first step of the examination is passed. The board may, by rule, establish exceptions to the time requirements of this subsection.

          [F.] I. Every applicant for licensure under this section shall pay the fees required by Section 61-6-19 NMSA 1978.

          [G.] J. The board may require fingerprints and other information necessary for a state and national criminal background check."

     SECTION 12. APPROPRIATION.--One million five hundred thousand dollars ($1,500,000) is appropriated from the general fund to the workforce solutions department for expenditure in fiscal year 2026 to implement and administer the provisions of the Immigrant Health Care Workforce Development Act, including hiring three full-time-equivalent department staff and providing program grants. Any unexpended or unencumbered balance remaining at the end of fiscal year 2026 shall revert to the general fund.

     SECTION 13. EFFECTIVE DATE.--The effective date of the provisions of this act is July 1, 2025.

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