0001| HOUSE BILL 433
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0002| 42ND LEGISLATURE - STATE OF NEW MEXICO - SECOND SESSION,
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0003| 1996
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0004| INTRODUCED BY
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0005| DAVID M. PARSONS
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0006|
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0007|
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0008|
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0009|
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0010|
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0011| AN ACT
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0012| RELATING TO PUBLIC ASSISTANCE; AMENDING PROVISIONS OF THE PUBLIC
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0013| ASSISTANCE ACT AND OTHER PROVISIONS OF LAW RELATED TO PUBLIC
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0014| ASSISTANCE TO ACCOMPLISH WELFARE REFORM; AMENDING, REPEALING AND
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0015| ENACTING SECTIONS OF THE NMSA 1978.
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0016|
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0017| BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:
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0018| Section 1. Section 27-2-1 NMSA 1978 (being Laws 1973,
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0019| Chapter 376, Section 1) is amended to read:
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0020| "27-2-1. SHORT TITLE.--Sections [1 through 20 of this act
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and Sections 13-1-9, 13-1-10, 13-1-12, 13-1-13, 13-1-17,
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13-1-18, 13-1-18.1, 13-1-19, 13-1-20, 13-1-20.1, 13-1-21,
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3-1-22, 13-1-27, 13-1-27.2, 13-1-27.3, 13-1-27.4, 13-1-28,
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13-1-28.6,13-1-29, 13-1-30, 13-1-34, 13-1-35, 13-1-37, 13-1-39,
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3-1-40, 13-1-41 and 13-1-42 NMSA 1953] 27-2-1 through 27-2-36
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0001| NMSA 1978 may be cited as the "Public Assistance Act"."
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0002| Section 2. Section 27-2-2 NMSA 1978 (being Laws 1973,
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0003| Chapter 376, Section 2, as amended) is repealed and a new
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0004| Section 27-2-2 NMSA 1978 is enacted to read:
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0005| "27-2-2. [NEW MATERIAL] DEFINITIONS.--
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0006| A. As used in the Public Assistance Act:
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0007| (1) "department" means the human services
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0008| department;
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0009| (2) "federal act" means the applicable federal
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0010| law authorizing or regulating, or both, a federally funded state
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0011| administered public welfare program;
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0012| (3) "public welfare" or "public assistance"
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0013| means aid, assistance or relief granted to or on behalf of an
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0014| eligible individual pursuant to the provisions of the Public
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0015| Assistance Act or regulations adopted pursuant to that act;
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0016| (4) "recipient" means an individual who
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0017| receives public assistance or services pursuant to the Public
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0018| Assistance Act; and
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0019| (5) "secretary" means the secretary of human
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0020| services.
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0021| B. As used in Chapter 27 NMSA 1978:
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0022| (1) "AFDC", "TANF", "aid to families with
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0023| dependent children" or "temporary assistance to needy families"
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0024| means the state and federal welfare programs of aid to families
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0025| with dependent children or temporary assistance to needy
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0001| families and similar programs that supersede or replace those
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0002| programs; and
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0003| (2) "medicaid" or "medigrant" means the state
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0004| and federal medical assistance programs authorized pursuant to
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0005| the federal act and known by those names and similar programs
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0006| that supersede or replace those programs."
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0007| Section 3. Section 27-2-4 NMSA 1978 (being Laws 1973,
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0008| Chapter 376, Section 4, as amended) is amended to read:
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0009| "27-2-4. GENERAL ELIGIBILITY REQUIREMENTS.--Consistent
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0010| with the federal act, a person is eligible for public assistance
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0011| grants under the Public Assistance Act if:
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0012| A. pursuant to Section [13-17-3 NMSA 1953] 27-2-3
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0013| NMSA 1978, the total amount of his nonexempt income is less
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0014| than the applicable standard of need; [and]
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0015| B. his nonexempt specific and total resources are
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0016| less than the level of maximum permissible resources established
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0017| by the [board; and] department;
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0018| C. he meets all qualifications for one of the public
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0019| assistance programs authorized by the Public Assistance Act; and
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0020| [D. within two years immediately prior to the
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filing of an application for assistance, he has not made an
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assignment or transfer of real property unless he has received a
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reasonable return for the real property or, if he has not
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received such
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reasonable return, he is willing to attempt to obtain such
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return and, if such attempt proves futile, he is willing to
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attempt to regain title to the property; and
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E.] D. he is not an inmate of any public
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0004| nonmedical institution at the time of receiving assistance [and
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F. he is a resident of New Mexico]."
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0006| Section 4. Section 27-2-5 NMSA 1978 (being Laws 1973,
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0007| Chapter 376, Section 5, as amended) is amended to read:
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0008| "27-2-5. AMOUNT AND FORM OF PUBLIC ASSISTANCE GRANT.--[A.] The amount and form of an eligible person's [maximum
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grant of] public assistance is determined [by deducting the
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total amount of his nonexempt income from the applicable
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standard of need. However, if the amount of federal and state
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funds available for public assistance is insufficient to provide
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the grants for all eligible persons, the amount of grants to
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eligible persons may be reduced as necessary.
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B. The secretary of human services may set
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individual and family maximum and minimum grant levels for each
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program] pursuant to regulations adopted by the department.
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0018| These regulations shall include provisions for public assistance
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0019| programs that:
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0020| A. are designed to operate within legislative
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0021| appropriations;
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0022| B. include provisions for cash benefits, payments to
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0023| vendors on behalf of recipients and other non-cash benefits;
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0024| C. authorize the secretary to establish individual
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0025| and family maximum public assistance grant levels for each
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0001| public assistance program;
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0002| D. include a prohibition of any type of maximum
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0003| grant predicated upon size or increase in size of the family to
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0004| which assistance is granted; and
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0005| E. are not more restrictive than permitted by
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0006| federal law."
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0007| Section 5. Section 27-2-6.1 NMSA 1978 (being Laws 1978,
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0008| Chapter 30, Section 1) is amended to read:
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0009| "27-2-6.1. SUPPLEMENTAL POSTNATAL ASSISTANCE.--The
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0010| [health and social services] department shall establish a
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0011| program of supplemental postnatal assistance for those mentally
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0012| retarded persons who during pregnancy received [aid]
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0013| temporary assistance to needy families [with dependent
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children] but whose [aid] assistance was [revoked]
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0015| terminated upon relinquishment of the newly born child for
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0016| adoption. The supplemental postnatal assistance provided for in
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0017| this section shall be [at the same rate as aid to families with
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dependent children] in the same form and amount as temporary
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0019| assistance to needy families, but [such] supplemental
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0020| postnatal assistance shall not [exceed a period of] continue
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0021| for more than sixty days. The [health and social services]
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0022| department shall [promulgate] adopt rules and regulations
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0023| [in order] to carry out the provisions of this section."
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0024| Section 6. Section 27-2-6.2 NMSA 1978 (being Laws 1988,
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0025| Chapter 122, Section 1) is amended to read:
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0001| "27-2-6.2. [PUBLIC] TEMPORARY ASSISTANCE TO NEEDY
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0002| FAMILIES--EMPLOYMENT [AND], TRAINING AND COMMUNITY SERVICE
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0003| ELIGIBILITY REQUIREMENTS--STATUS OF RECIPIENTS.--
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0004| [A. In the administration of all food stamp
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employment and training programs, community work experience
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programs, work incentive demonstration programs for recipients
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of aid to families with dependent children and all other work
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registration, work incentive or employment and training programs
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established or conducted by the human services department,
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participation of recipients shall be voluntary except as
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prohibited by federal law or when mandatory participation is a
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requirement in order to secure federal funding for services
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provided.
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B. Any waiver requests developed and submitted to
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the federal government by the human services department for food
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stamp employment and training programs, community work
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experience programs, work incentive demonstration programs for
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recipients of aid to families with dependent children and all
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other work registration, work incentive or employment, education
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and training programs shall include a voluntary program and may
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also include a mandatory alternative.
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C. The human services department shall promulgate
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regulations which shall be published and made available for
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public notice and comment which detail the criteria for
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mandatory participation and exemptions in accordance with
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federal law and regulations for persons in work, education,
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training, job search and work experience programs administered
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by the human services department prior to their implementation.
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D. The human services department shall not place
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persons in any community work experience or similar program
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unless:
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(1) appropriate standards for health, safety
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and other conditions applicable to the performance of work are
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met;
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(2) the program does not result in displacement of
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persons currently employed; and
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(3) provision is made for transportation, day
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care and other costs necessary and directly related to
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participation in the program]
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0015| A. Temporary assistance to needy families is
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0016| provided pursuant to regulations adopted by the department.
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0017| These regulations shall include provisions:
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0018| (1) authorizing the department to require as a
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0019| condition of eligibility for a recipient the participation by a
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0020| recipient in programs of employment, educational or training
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0021| services or community services; and
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0022| (2) that are no more restrictive than the
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0023| federal law permits.
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0024| B. A recipient who is employed, participating in a
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0025| training or educational program or providing community services
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0001| as a condition of eligibility for receipt of temporary
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0002| assistance to needy families is not an employee of the
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0003| department for any purposes, except as may be otherwise provided
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0004| in the Unemployment Compensation Law, and is not entitled to any
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0005| employee benefits. Acts of the recipient while employed or
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0006| providing community services are not attributable to the
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0007| department, and the department is not liable for damages caused
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0008| by those acts."
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0009| Section 7. Section 27-2-7 NMSA 1978 (being Laws 1973,
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0010| Chapter 376, Section 10, as amended) is amended to read:
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0011| "27-2-7. GENERAL ASSISTANCE PROGRAM--QUALIFICATIONS AND
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0012| PAYMENTS.--[A.] Subject to the availability of state funds,
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0013| public assistance shall be provided under a general assistance
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0014| program to [or on behalf of] eligible persons who:
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0015| [(1)] A. are under eighteen years of age and
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0016| meet all eligibility conditions for [aid] temporary
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0017| assistance to needy families [with dependent children]
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0018| except the relationship to the person with whom they are living;
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0019| [or
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(2)] B. are over the age of eighteen and are
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0021| temporarily disabled according to regulations of the [board]
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0022| department that incorporate a definition of "disabled" no more
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0023| restrictive than the definition of that term in the federal
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0024| Social Security Act and regulations adopted under it and who
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0025| are not receiving [aid] temporary assistance to needy
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0001| families [with dependent children]; or
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0002| [(3)] C. meet the qualifications under such
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0003| other regulations for the general assistance program as the
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0004| [board] department shall establish. [from time to time.
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B. General assistance program payments may be made
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directly to the recipient or to the vendor of goods or services
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provided to the recipient. The board may by regulation limit
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the grants that are made to general assistance recipients.
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C. Whenever the board makes an adjustment in the
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standard of need for the aid to families with dependent children
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program pursuant to Section 13-17-3 NMSA 1953, it shall make a
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commensurate adjustment in the standard of need for the general
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assistance program.]"
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0014| Section 8. Section 27-2-9 NMSA 1978 (being Laws 1973,
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0015| Chapter 376, Section 13) is amended to read:
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0016| "27-2-9. PAYMENT FOR HOSPITAL CARE.--
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0017| A. Consistent with the federal act, the department
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0018| shall provide necessary hospital care for recipients of public
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0019| assistance other than those eligible under the general
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0020| assistance program authorized by Section [10 of the Public
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Assistance Act] 27-2-7 NMSA 1978. [The rate of] Payment
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0022| for inpatient hospital services shall be [based either on the
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reasonable cost or the customary cost of such services,
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whichever is less. In determining reasonable cost under this
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section, the board shall adopt regulations establishing a
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formula]:
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0002| (1) at the rate established by regulations
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0003| adopted by the department that are consistent with the federal
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0004| act [The department shall apply that formula to determine the
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amount to which each hospital is entitled as reimbursement for
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providing in-patient hospital services]; or
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0007| (2) if the hospital care is provided pursuant
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0008| to a managed care contract, at a rate or in an amount determined
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0009| as provided in that contract.
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0010| B. To receive reimbursement for providing in-patient
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0011| hospital services, a hospital shall file annually with the
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0012| department [such] information as required by the department
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0013| [may reasonably require to determine reasonable costs or the
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hospital's customary cost of in-patient hospital services]
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0015| pursuant to its regulations.
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0016| C. [Any] A hospital entitled to reimbursement
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0017| for in-patient hospital services [shall be] is entitled to a
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0018| hearing, pursuant to regulations of the [board consistent with
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applicable state law] department if the hospital disagrees
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0020| with the department's determination of the reimbursement the
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0021| hospital is to receive."
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0022| Section 9. Section 27-2-12.3 NMSA 1978 (being Laws 1987,
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0023| Chapter 269, Section 1) is amended to read:
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0024| "27-2-12.3. MEDICAID OR MEDIGRANT REIMBURSEMENT [EQUAL
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PAY FOR EQUAL PHYSICIANS', DENTISTS', OPTOMETRISTS',
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PODIATRISTS' AND PSYCHOLOGISTS' SERVICES].--The [human
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services] department shall establish [a rate] rates by
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0003| regulation for the reimbursement of [physicians, dentists,
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optometrists, podiatrists and psychologists for] providers of
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0005| services rendered to medicaid or medigrant patients [that
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provides equal reimbursement for the same or similar services
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rendered without respect to the date on which such physician,
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dentist, optometrist, podiatrist or psychologist entered into
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practice in New Mexico, the date on which the physician,
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dentist, optometrist, podiatrist or psychologist entered into an
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agreement or contract to provide such services or the location
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in which such services are to be provided in the state]."
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0013| Section 10. Section 27-2-12.4 NMSA 1978 (being Laws 1987,
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0014| Chapter 214, Section 1) is amended to read:
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0015| "27-2-12.4. LONG-TERM CARE FACILITIES--[NONCOMPLIANCE
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WITH] STANDARDS AND CONDITIONS.--[SANCTIONS.--
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A. In addition to any other actions required or
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permitted by federal law or regulation, the human services
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department shall impose a hold on state medicaid payments to a
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long-term care facility thirty days after the health and
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environment department notifies the human services department in
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writing pursuant to an on-site visit that the long-term care
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facility is not in substantial compliance with the standards or
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conditions of participation promulgated by the federal
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department of health and human services pursuant to which the
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facility is a party to a medicaid provider agreement, unless the
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substantial noncompliance has been corrected within that thirty-day period or the facility's medicaid provider agreement is
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terminated or not renewed based in whole or in part on the
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noncompliance. The written notice shall cite the specific
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deficiencies that constitute noncompliance.
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B. The human services department shall remove the
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payment hold imposed under Subsection A of this section when the
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health and environment department, pursuant to an on-site visit,
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certifies in writing to the human services department that the
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long-term care facility is in substantial compliance with the
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standards or conditions of participation pursuant to which the
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facility is a party to a medicaid provider agreement.
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C. The human services department shall not reimburse
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any long-term care facility during the payment hold period
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imposed pursuant to Subsection A of this section for any
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medicaid recipient-patients who are new admissions and who are
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admitted on or after the day the hold is imposed and prior to
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the day the hold is removed.
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D. If a long-term care facility is certified in
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writing to be in noncompliance pursuant to Subsection A of this
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section for the second time in any twelve-month period, the
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human services department shall cancel or refuse to execute the
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long-term care facility's medicaid provider agreement for a two-month period, unless it can be demonstrated that harm to the
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patients would result from this action or that good cause exists
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to allow the facility to continue to participate in the medicaid
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program. The provisions of this subsection are subject to
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appeal procedures set forth in federal regulations for
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nonrenewal or termination of a medicaid provider agreement.
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E. A long-term care facility shall not charge
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medicaid recipient-patients, their families or their responsible
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parties to recoup any payments not received because of a hold on
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medicaid payments imposed pursuant to this section.
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F. This section shall not be construed to affect any
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other provisions for medicaid provider agreement termination,
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nonrenewal, due process and appeal pursuant to federal law or
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regulation.
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G. As used in this section:
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(1) "day" means a twenty-four hour period
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beginning at midnight and ending one second before midnight;
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(2) "long-term care facility" means any
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intermediate care facility or skilled nursing facility which is
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licensed by the health and environment department and which is
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medicaid certified;
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(3) "new admissions" means medicaid recipients
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who have never been in the long-term care facility or, if
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previously admitted, had been discharged or had voluntarily left
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the facility. The term does not include:
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(a) individuals who were in the long-term
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care facility before the effective date of the hold on medicaid
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payments and became eligible for medicaid after that date; and
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(b) individuals who, after a temporary
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absence from the facility, are readmitted to beds reserved for
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them in accordance with federal regulations; and
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(4) "substantial compliance" means the
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condition of having no cited deficiencies or having only those
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cited deficiencies which:
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(a) are not inconsistent with any federal
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statutory requirement;
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(b) do not interfere with adequate
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patient care;
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(c) do not represent a hazard to the
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patients' health or safety;
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(d) are capable of correction within a
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reasonable period of time; and
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(e) are ones which the long-term care
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facility is making reasonable plans to correct]
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0017| A. Long-term care facilities participating in the
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0018| federal medicaid or medigrant program shall comply with the
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0019| licensure, certification and reimbursement requirements
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0020| established in state and federal law applicable to participation
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0021| in the program.
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0022| B. Long-term care facility licensure, certification
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0023| and participation requirements of the federal medicaid or
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0024| medigrant program shall be enforced by the human services
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0025| department and the department of health.
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0001| C. The human services department and the department
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0002| of health may adopt by regulation medicaid or medigrant
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0003| certification standards for long-term care facilities
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0004| participating in the federal medicaid or medigrant program."
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0005| Section 11. Section 27-2-12.5 NMSA 1978 (being Laws 1989,
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0006| Chapter 83, Section 1, as amended) is amended to read:
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0007| "27-2-12.5. MEDICAID- OR MEDIGRANT-CERTIFIED NURSING
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0008| FACILITIES--RETROACTIVE ELIGIBILITY--REFUNDS--PENALTY.--
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0009| A. A medicaid or medigrant payment for a
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0010| medicaid- or medigrant-eligible patient shall be accepted by a
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0011| medicaid- or medigrant-certified nursing facility from the
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0012| first month of medicaid or medigrant eligibility, regardless
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0013| of whether the eligibility is retroactive. The nursing facility
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0014| shall refund to the patient or responsible party all out-of-pocket money except for required medical-care credits paid to
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0015| the nursing facility for that patient's care on and after the
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0016| date of medicaid or medigrant eligibility for services covered
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0017| by the medicaid or medigrant program. Within thirty days
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0018| after notification by the human services department of the
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0019| patient's medicaid or medigrant eligibility, the nursing
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0020| facility shall make any necessary refund to the patient or
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0021| responsible party required under this section.
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0022| B. In any cause of action brought against a nursing
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0023| facility because of its failure to make a refund to the patient
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0024| or responsible party as required under Subsection A of this
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0025| section, the patient or responsible party may be awarded triple
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0001| the amount of the money not refunded or three hundred dollars
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0002| ($300), whichever is greater, and reasonable attorneys' fees and
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0003| court costs."
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0004| Section 12. Section 27-2-12.6 NMSA 1978 (being Laws 1994,
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0005| Chapter 62, Section 22) is amended to read:
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0006| "27-2-12.6. MEDICAID OR MEDIGRANT PAYMENTS--MANAGED
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0007| CARE.--
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0008| A. The department shall provide for a statewide,
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0009| managed care system to provide cost-efficient, preventive,
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0010| primary and acute care for medicaid or medigrant recipients
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0011| [by July 1, 1995].
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0012| B. The managed care system shall ensure:
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0013| (1) access to medically necessary services,
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0014| particularly for medicaid or medigrant recipients with chronic
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0015| health problems;
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0016| (2) to the extent practicable, maintenance of
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0017| the rural primary care delivery infrastructure;
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0018| (3) that the department's approach is
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0019| consistent with national and state health care reform
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0020| principles; and
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0021| (4) to the maximum extent possible, that
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0022| medicaid- or medigrant-eligible individuals are not identified
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0023| as such except as necessary for billing purposes.
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0024| C. The department may exclude nursing homes,
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0025| intermediate care facilities for the mentally retarded, medicaid
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0001| or medigrant in-home and community-based waiver services and
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0002| residential and community-based mental health services for
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0003| children with serious emotional disorders from the provisions of
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0004| this section."
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0005| Section 13. Section 27-2-23.1 NMSA 1978 (being Laws 1989,
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0006| Chapter 184, Section 1) is amended to read:
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0007| "27-2-23.1. EMPLOYEE RETIREMENT INCOME SECURITY ACT
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0008| EMPLOYEE HEALTH BENEFIT PLANS--CLAUSES TO EXCLUDE MEDICAID OR
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0009| MEDIGRANT COVERAGE PROHIBITED.--No employee health benefit plan
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0010| established under the Employee Retirement Income Security Act of
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0011| 1974, 29 [U.S.C.] U.S.C.A. 1144 that provides payments for
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0012| health care on behalf of individuals residing in the state shall
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0013| contain any provisions excluding or limiting coverage or payment
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0014| for any health care for an individual who would otherwise be
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0015| covered or entitled to benefits or services under the terms of
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0016| the employee health benefit plan because that individual is
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0017| provided or is eligible for benefits under the medicaid or
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0018| medigrant program of this state pursuant to [Title XIX of]
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0019| the federal [Social Security Act, 42 U.S.C. 1396, et seq]
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0020| act."
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0021| Section 14. Section 27-2-27 NMSA 1978 (being Laws 1981,
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0022| Chapter 90, Section 1, as amended) is amended to read:
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0023| "27-2-27. SINGLE STATE AGENCY--POWERS AND DUTIES.--
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0024| A. The department is designated as the single
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0025| state agency for the enforcement of child and spousal support
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0001| obligations pursuant to [Title IV D of] the federal act with
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0002| the following duties and powers:
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0003| [A.] (1) establish the paternity of a child
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0004| in the case of the child born out of wedlock with respect to
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0005| whom an assignment of support rights has been executed in favor
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0006| of the department;
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0007| [B.] (2) establish an order of support for
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0008| children receiving [aid] temporary assistance to needy
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0009| families [with dependent children] and, at the option of the
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0010| department, for the spouse or former spouse with whom such
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0011| children are living, but only if a support obligation has been
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0012| established with respect to such spouse or former spouse, for
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0013| whom no order of support [presently] currently exists, and
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0014| seek modification, based upon the noncustodial parent's ability
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0015| to pay, of existing orders in which the support order is
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0016| inadequate to properly care for the child and the spouse or
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0017| former spouse with whom the child is living;
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0018| [C.] (3) enforce as the real party in
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0019| interest any existing order for the support of children who are
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0020| receiving [aid] temporary assistance to needy families
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0021| [with dependent children] or of the spouse or former spouse
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0022| with whom such children are living; and
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0023| [D.] (4) provide services to [non-aid]
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0024| families with dependent children not receiving temporary
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0025| assistance to needy families in the establishment and
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0001| enforcement of paternity and child support obligations,
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0002| including locating the absent parent. For these services, the
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0003| department is authorized to establish and collect fees, costs
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0004| and charges permitted or required by federal law or by regula-
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0005| tions adopted pursuant to that federal law.
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0006| [E.] B. In all cases handled by the department
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0007| pursuant to the provisions of this section, the child support
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0008| enforcement division of the department and any attorney employed
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0009| by the division represent the department in establishing,
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0010| modifying and enforcing support obligations."
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0011| Section 15. Section 27-2-28 NMSA 1978 (being Laws 1981,
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0012| Chapter 90, Section 2, as amended) is amended to read:
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0013| "27-2-28. LIABILITY FOR REPAYMENT OF PUBLIC
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0014| ASSISTANCE.--
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0015| A. A noncustodial parent is liable to the [human
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services] department [in] for the amount of the public
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0017| assistance lawfully and properly furnished to the children, and
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0018| the spouse or former spouse with whom such children are living,
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0019| to whom the noncustodial parent owes a duty of support; except
|
0020| that if a support order has been entered, liability for the time
|
0021| period covered by the support order shall not exceed the amount
|
0022| of support provided for in the order.
|
0023| B. Amounts of support due and owing for periods
|
0024| prior to the granting of public assistance shall be paid to and
|
0025| retained by the [human services] department to the extent that
|
0001| the amount of assistance granted exceeds the amount of the
|
0002| monthly support obligation.
|
0003| C. Amounts of support collected that are in excess
|
0004| of the amounts specified in Subsections A and B of this section
|
0005| shall be paid by the [human services] department to the
|
0006| custodian of the child.
|
0007| D. No agreement between any custodian of a child and
|
0008| a parent of that child, either relieving the parent of any duty
|
0009| of child or spousal support or responsibility or purporting to
|
0010| settle past, present or future support obligations, either as a
|
0011| settlement or prepayment, shall act to reduce or terminate any
|
0012| rights of the [human services] department to recover from that
|
0013| parent for support provided unless the [human services]
|
0014| department has consented to the agreement in writing.
|
0015| E. The noncustodial parent shall be given credit for
|
0016| any support actually provided, including housing, clothing, food
|
0017| or funds paid prior to the entry of any order for support. The
|
0018| noncustodial parent has the burden on the issue of any payment.
|
0019| F. An application for public assistance by any
|
0020| person constitutes an assignment by operation of law of any
|
0021| support rights the person is entitled to from any other person,
|
0022| whether the support rights are owed to the applicant or to any
|
0023| family member for whom the applicant is applying for or
|
0024| receiving assistance. The assignment includes all support
|
0025| rights that have accrued at the time of application for public
|
0001| assistance and continues as an assignment of all support rights
|
0002| the applicant is entitled to for as long as the applicant
|
0003| receives public assistance.
|
0004| G. By operation of law, an assignment to the [human
|
services] department of any and all rights of an applicant for
|
0006| or recipient of medical assistance under the medicaid or
|
0007| medigrant program in New Mexico or supplemental security income
|
0008| through the social security administration:
|
0009| (1) is deemed to be made of:
|
0010| (a) any payment for medical care from any
|
0011| person, firm or corporation, including an insurance carrier; and
|
0012| (b) any recovery for personal injury,
|
0013| whether by judgment or contract for compromise or settlement;
|
0014| (2) shall be effective to the extent of the
|
0015| amount of medical assistance actually paid by the department
|
0016| under the medicaid or medigrant program; and
|
0017| (3) shall be effective as to the rights of any
|
0018| other individuals who are eligible for medical assistance and
|
0019| whose rights can legally be assigned by the applicant or
|
0020| recipient.
|
0021| An applicant or recipient is required to cooperate fully
|
0022| with the [human services] department in its efforts to secure
|
0023| the assignment and to execute and deliver any instruments and
|
0024| papers deemed necessary to complete the assignment by [that]
|
0025| the department."
|
0001| Section 16. Section 27-2-35 NMSA 1978 (being Laws 1941,
|
0002| Chapter 116, Section 1, as amended) is amended to read:
|
0003| "27-2-35. CUSTODY OF RECORDS--DISCLOSURE OF INFORMATION.--
|
0004| The [New Mexico] department [of public welfare shall have]
|
0005| has the power to [establish] adopt and enforce reasonable
|
0006| rules and regulations governing the custody, use and
|
0007| preservation of the records, papers, files and communications of
|
0008| [its state and county departments] the department and to
|
0009| restrict the use or disclosure of information contained therein
|
0010| concerning applications for and recipients of assistance of any
|
0011| kind to purposes directly connected with the administration of
|
0012| [the Public Welfare Act] Chapter 27 NMSA 1978 and of any
|
0013| related federal act, except as [hereinafter] otherwise
|
0014| provided by an applicable state or federal law.
|
0015| [a. RECORDS OPEN TO INSPECTION-EXCEPTIONS. The
|
department of public welfare shall, on or before the last day of
|
each month, make available in the county office of the
|
department of public welfare of each county a complete list
|
showing all the names and addresses of all the recipients
|
receiving payments under the Public Welfare Act within that
|
county for the preceding month, together with the amount paid
|
each during the said month. The reports shall be securely bound
|
in a separate record book provided for that purpose which said.
|
Book and all reports contained therein shall be, and the same
|
hereby are declared to be public records and shall be open to
|
public inspection at all times during the regular office hours
|
of said office, subject to rules and regulations of the
|
department. Provided, however, that nothing herein contained
|
shall be construed to authorize or require the disclosure of any
|
record of the public welfare department pertaining to adoptions.
|
b. UNLAWFUL USES. Except as provided in this
|
Act, it shall be unlawful for any person, body, association,
|
firm corporation or any other agency to solicit, disclose,
|
receive make use of or to authorize, knowingly permit,
|
participate in or acquiesce in the use of any name or list of
|
names for commercial or political purposes of any nature.
|
c. PENALTY. Any person, body, association,
|
corporation or any other agency who shall wilfully or knowingly
|
violate any provision of this act, shall be guilty of a
|
misdemeanor and upon conviction shall be punished by a fine of
|
not less than twenty five dollars ($25.00) nor more than one
|
thousand dollars ($1,000), to which may be added imprisonment in
|
the county jail for any term or period not to exceed sixty
|
days.]"
|
0020| Section 17. Section 27-2-43 NMSA 1978 (being Laws 1990,
|
0021| Chapter 93, Section 3) is amended to read:
|
0022| "27-2-43. DEFINITIONS.--As used in the Indigent
|
0023| Catastrophic Illness Hospital Funding Act:
|
0024| A. "department" means the human services department;
|
0025| B. "fund" means the indigent catastrophic illness
|
0001| hospital fund;
|
0002| C. "hospital" means any general or special hospital
|
0003| that is licensed by the [health and environment] department
|
0004| of health and that has annual gross charges for medicare,
|
0005| medicaid, [and] medigrant or indigent patients greater than
|
0006| ten percent of the hospital's total annual gross charges; and
|
0007| D. "medically indigent patient" means an individual
|
0008| who is a New Mexico resident who incurs hospital charges, who is
|
0009| not eligible for medicaid, medigrant or medicare and whose
|
0010| family or household income does not exceed two hundred fifty
|
0011| percent of the federal poverty level."
|
0012| Section 18. Section 27-7-16 NMSA 1978 (being Laws 1989,
|
0013| Chapter 389, Section 3, as amended) is amended to read:
|
0014| "27-7-16. DEFINITIONS.--As used in the Adult Protective
|
0015| Services Act:
|
0016| A. "abuse" means:
|
0017| (1) knowingly, intentionally or negligently and
|
0018| without justifiable cause inflicting physical pain, injury or
|
0019| mental anguish; or
|
0020| (2) the intentional deprivation by a caretaker
|
0021| or other person of services necessary to maintain the mental and
|
0022| physical health of an adult;
|
0023| B. "adult" means a person eighteen years of age or
|
0024| older;
|
0025| C. "appropriate facility" means any facility other
|
0001| than a jail or detention facility;
|
0002| D. "caretaker" means an individual or institution
|
0003| that has assumed the responsibility for the care of an adult;
|
0004| E. "conservator" means a person who is appointed by
|
0005| a court to manage the estate of a protected adult;
|
0006| F. "court" means the district court having
|
0007| jurisdiction;
|
0008| G. "department" means the [human services]
|
0009| children, youth and families department;
|
0010| H. "emergency" means that an adult is living in
|
0011| conditions that present a substantial risk of death or immediate
|
0012| and serious physical harm to himself or others;
|
0013| I. "exploitation" means an unjust or improper use of
|
0014| an adult's resources for another's profit or advantage,
|
0015| pecuniary or otherwise;
|
0016| J. "guardian" means a person who is a guardian of an
|
0017| incapacitated adult pursuant to a court order;
|
0018| K. "incapacitated adult" means any adult who
|
0019| demonstrates over time partial or complete functional impairment
|
0020| by reason of mental illness, mental deficiency, physical illness
|
0021| or disability, chronic use of drugs, chronic intoxication or
|
0022| other causes to the extent that he is unable to manage his
|
0023| personal care or he is unable to manage his personal property
|
0024| and financial affairs;
|
0025| L. "independent living arrangements" means a mode of
|
0001| life maintained on a continuing basis outside of a hospital,
|
0002| veterans' administration hospital, nursing home or other
|
0003| facility licensed by or under the jurisdiction of any state
|
0004| agency;
|
0005| M. "interested person" means any adult relative, any
|
0006| person who has an interest in the welfare of the adult to be
|
0007| protected under the Adult Protective Services Act or any
|
0008| official or representative of a protective services agency or of
|
0009| any public or nonprofit agency, corporation, board or
|
0010| organization eligible for designation as a protective services
|
0011| agency;
|
0012| N. "neglect" means failure of the caretaker of an
|
0013| adult to provide basic needs such as clothing, food, shelter,
|
0014| supervision and care for the physical and mental health for that
|
0015| adult or failure by an adult to provide such basic needs for
|
0016| himself;
|
0017| O. "protected adult" means an adult for whom a
|
0018| guardian or conservator has been appointed or other protective
|
0019| order has been made;
|
0020| P. "protective placement" means the transfer of an
|
0021| adult from independent living arrangements to a hospital,
|
0022| nursing home, domiciliary or residential care facility, or from
|
0023| one such institution to another;
|
0024| Q. "protective services" means the services
|
0025| furnished by the department or a protective services agency or
|
0001| its delegate, as described in Section 27-7-21 NMSA 1978; and
|
0002| R. "protective services agency" means a corporation,
|
0003| board or organization authorized by the department pursuant to
|
0004| the Adult Protective Services Act to furnish protective services
|
0005| to protected or incapacitated adults or to serve as conservators
|
0006| or guardians of protected or incapacitated adults upon
|
0007| appointment by a court."
|
0008| Section 19. REPEAL.--Sections 27-2-37 through 27-2-40 NMSA
|
0009| 1978 (being Laws 1980, Chapter 25, Sections 1 through 4, as
|
0010| amended) are repealed.
|
0011| - 27 -
|
0012| State of New Mexico
|
0013| House of Representatives
|
0014|
|
0015| FORTY-SECOND LEGISLATURE
|
0016| SECOND SESSION, 1996
|
0017|
|
0018|
|
0019| February 8, 1996
|
0020|
|
0021|
|
0022| Mr. Speaker:
|
0023|
|
0024| Your CONSUMER AND PUBLIC AFFAIRS COMMITTEE, to
|
0025| whom has been referred
|
0001|
|
0002| HOUSE BILL 433
|
0003|
|
0004| has had it under consideration and reports same with
|
0005| recommendation that it DO PASS, amended as follows:
|
0006|
|
0007| 1. On page 2, line 22, strike ", "TANF"," and insert in lieu
|
0008| thereof "or".
|
0009|
|
0010| 2. On page 2, line 23, strike "or "temporary assistance to
|
0011| needy families"".
|
0012|
|
0013| 3. On page 2, line 25, after "children" strike the remainder
|
0014| of the line, and on page 3, line 1, strike "families".
|
0015|
|
0016| 4. On page 3, line 3, strike "or medigrant"".
|
0017|
|
0018| 5. On page 3, line 9, before "Consistent" insert "A.".
|
0019|
|
0020| 6. On page 3, line 12, strike "A." and insert in lieu
|
0021| thereof "(1)".
|
0022|
|
0023| 7. On page 3, line 15, strike "B." and insert in lieu
|
0024| thereof "(2)".
|
0025|
|
0001| 8. On page 3, line 18, strike "C." and insert in lieu
|
0002| thereof "(3)".
|
0003|
|
0004| 9. On page 4, line 2, strike "D." and insert in lieu thereof
|
0005| "(4)".
|
0006|
|
0007| 10. On page 4, line 4, strike the quotation marks.
|
0008|
|
0009| 11. On page 4, between lines 4 and 5, insert:
|
0010|
|
0011| "B. For the purposes of determining eligibility
|
0012| pursuant to the provisions of this section the standard of need in
|
0013| effect on January 1, 1996 shall remain in effect thereafter and
|
0014| shall not be reduced or restricted."".
|
0015|
|
0016| 12. On page 5, strike all of lines 7 through 23.
|
0017|
|
0018| 13. Renumber the succeeding sections accordingly.
|
0019|
|
0020| 14. On page 6, lines 1 and 2, strike "PUBLIC TEMPORARY
|
0021| ASSISTANCE TO NEEDY FAMILIES" and insert in lieu thereof "AID TO
|
0022| FAMILIES WITH DEPENDENT CHILDREN".
|
0023|
|
0024| 15. On page 7, line 15, strike "Temporary assistance to
|
0025| needy families" and insert in lieu thereof "Aid to families with
|
0001| dependent children".
|
0002|
|
0003| 16. On page 7, between lines 23 and 24, insert the following
|
0004| new subsections to read:
|
0005|
|
0006| "B. The department shall not impose the condition of
|
0007| eligibility authorized pursuant to Paragraph (1) of Subsection A
|
0008| of this section on an applicant or recipient for assistance if:
|
0009|
|
0010| (1) the applicant or recipient is disabled within
|
0011| the meaning of that term as used in the federal Social Security
|
0012| Act;
|
0013|
|
0014| (2) the applicant or recipient lacks financial
|
0015| resources for or has insufficient geographic access to adequate
|
0016| child care;
|
0017|
|
0018| (3) the applicant or recipient is sixty years of
|
0019| age or older; or
|
0020|
|
0021| (4) a child under the age of one year is included
|
0022| in the household of an applicant or recipient who is the parent or
|
0023| stands in the relationship of parent to that child.
|
0024|
|
0025| C. The department shall not place an individual in or
|
0001| require an individual to accept employment pursuant to the
|
0002| provisions of Paragraph (1) of Subsection A of this section if the
|
0003| proposed employment:
|
0004|
|
0005| (1) is not in a work setting having adequate
|
0006| standards for health, safety and other conditions applicable to
|
0007| the performance of the work; or
|
0008|
|
0009| (2) would result in the displacement of an
|
0010| existing worker.".
|
0011|
|
0012| 17. On page 7, line 24, strike "B." and insert in lieu
|
0013| thereof "D."
|
0014|
|
0015| 18. On page 8, lines 1 and 2, strike "temporary assistance
|
0016| to needy families" and insert in lieu thereof "aid to families
|
0017| with dependent children".
|
0018|
|
0019| 19. On page 8, line 16, remove the brackets and line through
|
0020| "aid" and strike "temporary assistance".
|
0021|
|
0022| 20. On page 8, line 17, strike "needy" and remove the
|
0023| brackets and line through "with dependent children".
|
0024|
|
0025| 21. On page 8, line 24, remove the brackets and line through
|
0001| "aid", strike "temporary assistance" and strike "needy"
|
0002|
|
0003| 22. On page 8, lines 24 and 25, remove the brackets and line
|
0004| through "with dependent children".
|
0005|
|
0006| 23. On page 10, line 23, strike "OR MEDIGRANT".
|
0007|
|
0008| 24. On page 11, line 4, strike "or medigrant".
|
0009|
|
0010| 25. On page 11, strike all of lines 12 through 25.
|
0011|
|
0012| 26. Strike pages 12 through 15 and on page 16, strike lines
|
0013| 1 through 5 in their entirety.
|
0014|
|
0015| 27. Renumber the succeeding sections accordingly.
|
0016|
|
0017| 28. On page 16, line 8, strike "OR MEDIGRANT".
|
0018|
|
0019| 29. On page 16, line 12, strike "or medigrant".
|
0020|
|
0021| 30. On page 16, line 16, strike "or medigrant".
|
0022|
|
0023| 31. On page 16, line 24, strike "- or medigrant".
|
0024|
|
0025| 32. On page 17, line 3, strike "or medigrant".
|
0001|
|
0002| 33. On page 17, strike all of lines 7 through 25, strike
|
0003| pages 18 through 23 and on page 24, strike lines 1 through 12 in
|
0004| their entirety.
|
0005|
|
0006| 34. Renumber the succeeding sections accordingly.
|
0007|
|
0008| 35. On page 27, between lines 11 and 12, insert the
|
0009| following new sections:
|
0010|
|
0011| "Section 20. APPLICABILITY.--
|
0012|
|
0013| A. The provisions of this act shall apply to an
|
0014| individual submitting a new application for benefits after its
|
0015| effective date.
|
0016|
|
0017| B. The provisions of this act shall not apply to an
|
0018| individual already receiving benefits on July 1, 1996, but shall
|
0019| apply to that individual on the date of recertification for
|
0020| benefits for the individual occurring after July 1, 1996.
|
0021|
|
0022| Section 21. EFFECTIVE DATE.--The effective date of the
|
0023| provisions of this act is July 1, 1996.",
|
0024|
|
0025| and thence referred to the JUDICIARY COMMITTEE.
|
0001|
|
0002| Respectfully submitted,
|
0003|
|
0004|
|
0005|
|
0006|
|
0007| Gary K. King, Chairman
|
0008|
|
0009|
|
0010| Adopted Not Adopted
|
0011|
|
0012| (Chief Clerk) (Chief Clerk)
|
0013|
|
0014| Date
|
0015|
|
0016| The roll call vote was 7 For 1 Against
|
0017| Yes: 7
|
0018| No: Charley
|
0019| Excused: Baca, Sandel, Vigil
|
0020| Absent: None
|
0021|
|
0022|
|
0023| .111937.1
|
0024| H0433CP1 State of New Mexico
|
0025| House of Representatives
|
0001|
|
0002| FORTY-SECOND LEGISLATURE
|
0003| SECOND SESSION, 1996
|
0004|
|
0005|
|
0006| February 12, 1996
|
0007|
|
0008|
|
0009| Mr. Speaker:
|
0010|
|
0011| Your JUDICIARY COMMITTEE, to whom has been referred
|
0012|
|
0013| HOUSE BILL 433, as amended
|
0014|
|
0015| has had it under consideration and reports same with
|
0016| recommendation that it DO NOT PASS, but that
|
0017|
|
0018| HOUSE JUDICIARY COMMITTEE SUBSTITUTE
|
0019| FOR HOUSE BILL 433
|
0020|
|
0021| DO PASS, and thence referred to the APPROPRIATIONS AND
|
0022| FINANCE COMMITTEE.
|
0023|
|
0024| Respectfully submitted,
|
0025|
|
0001|
|
0002|
|
0003|
|
0004| Cisco McSorley, Chairman
|
0005|
|
0006|
|
0007| Adopted Not Adopted
|
0008|
|
0009| (Chief Clerk) (Chief Clerk)
|
0010|
|
0011| Date
|
0012|
|
0013| The roll call vote was 10 For 1 Against
|
0014| Yes: 10
|
0015| No: McSorley
|
0016| Excused: Alwin, Sanchez, R.G.
|
0017| Absent: None
|
0018|
|
0019|
|
0020|
|
0021| H0433JC1 HOUSE JUDICIARY COMMITTEE SUBSTITUTE FOR
|
0022| HOUSE BILL 433
|
0023| 42nd legislature - STATE OF NEW MEXICO - second session, 1996
|
0024|
|
0025|
|
0001|
|
0002|
|
0003|
|
0004|
|
0005|
|
0006| AN ACT
|
0007| RELATING TO PUBLIC ASSISTANCE; AMENDING PROVISIONS OF THE PUBLIC
|
0008| ASSISTANCE ACT AND OTHER PROVISIONS OF LAW RELATED TO PUBLIC
|
0009| ASSISTANCE TO ACCOMPLISH WELFARE REFORM; AMENDING, REPEALING AND
|
0010| ENACTING SECTIONS OF THE NMSA 1978.
|
0011|
|
0012| BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:
|
0013| Section 1. Section 27-2-1 NMSA 1978 (being Laws 1973,
|
0014| Chapter 376, Section 1) is amended to read:
|
0015| "27-2-1. SHORT TITLE.--Sections [1 through 20 of this act
|
and Sections 13-1-9, 13-1-10, 13-1-12, 13-1-13, 13-1-17,
|
13-1-18, 13-1-18.1, 13-1-19, 13-1-20, 13-1-20.1, 13-1-21,
|
3-1-22, 13-1-27, 13-1-27.2, 13-1-27.3, 13-1-27.4, 13-1-28,
|
13-1-28.6,13-1-29, 13-1-30, 13-1-34, 13-1-35, 13-1-37, 13-1-39,
|
3-1-40, 13-1-41 and 13-1-42 NMSA 1953] 27-2-1 through 27-2-36
|
0021| NMSA 1978 may be cited as the "Public Assistance Act"."
|
0022| Section 2. Section 27-2-2 NMSA 1978 (being Laws 1973,
|
0023| Chapter 376, Section 2, as amended) is repealed and a new
|
0024| Section 27-2-2 NMSA 1978 is enacted to read:
|
0025| "27-2-2. [NEW MATERIAL] DEFINITIONS.--
|
0001| A. As used in the Public Assistance Act:
|
0002| (1) "department" means the human services
|
0003| department;
|
0004| (2) "federal act" means the applicable federal
|
0005| law authorizing or regulating, or both, a federally funded state
|
0006| administered public welfare program;
|
0007| (3) "public welfare" or "public assistance"
|
0008| means aid, assistance or relief granted to or on behalf of an
|
0009| eligible individual pursuant to the provisions of the Public
|
0010| Assistance Act or regulations adopted pursuant to that act;
|
0011| (4) "recipient" means an individual who
|
0012| receives public assistance or services pursuant to the Public
|
0013| Assistance Act; and
|
0014| (5) "secretary" means the secretary of human
|
0015| services.
|
0016| B. As used in Chapter 27 NMSA 1978:
|
0017| (1) "AFDC" or "aid to families with dependent
|
0018| children" means the state and federal welfare programs of aid to
|
0019| families with dependent children and similar programs that
|
0020| supersede or replace those programs; and
|
0021| (2) "medicaid" means the state and federal
|
0022| medical assistance programs authorized pursuant to the federal
|
0023| act and known by those names and similar programs that supersede
|
0024| or replace those programs."
|
0025| Section 3. Section 27-2-4 NMSA 1978 (being Laws 1973,
|
0001| Chapter 376, Section 4, as amended) is amended to read:
|
0002| "27-2-4. GENERAL ELIGIBILITY REQUIREMENTS.--Consistent
|
0003| with the federal act, a person is eligible for public assistance
|
0004| grants under the Public Assistance Act if:
|
0005| A. pursuant to Section [13-17-3 NMSA 1953] 27-2-3 NMSA 1978, the total amount of his nonexempt income is less
|
0006| than the applicable standard of need; [and]
|
0007| B. his nonexempt specific and total resources
|
0008| are less than the level of maximum permissible resources
|
0009| established by the [board; and] department;
|
0010| C. he meets all qualifications for one of the
|
0011| public assistance programs authorized by the Public Assistance Act;
|
0012| and
|
0013| [D. within two years immediately prior to the filing
|
of an application for assistance, he has not made an assignment or
|
transfer of real property unless he has received a reasonable
|
return for the real property or, if he has not received such
|
reasonable return, he is willing to attempt to obtain such return
|
and, if such attempt proves futile, he is willing to attempt to
|
regain title to the property; and
|
E.] D. he is not an inmate of any public
|
0021| nonmedical institution at the time of receiving assistance [and
|
F. he is a resident of New Mexico]."
|
0023| Section 4. Section 27-2-5 NMSA 1978 (being Laws 1973,
|
0024| Chapter 376, Section 5, as amended) is amended to read:
|
0025| "27-2-5. AMOUNT AND FORM OF PUBLIC ASSISTANCE GRANT.--[A.] The amount and form of an eligible person's [maximum
|
grant of]
|
0002| public assistance is determined [by deducting the total amount of
|
his nonexempt income from the applicable standard of need. However,
|
if the amount of federal and state funds available for public
|
assistance is insufficient to provide the grants for all eligible
|
persons, the amount of grants to eligible persons may be reduced as
|
necessary.
|
B. The secretary of human services may set individual
|
and family maximum and minimum grant levels for each program]
|
0010| pursuant to regulations adopted by the department. These
|
0011| regulations shall include provisions for public assistance programs
|
0012| that:
|
0013| A. are designed to operate within legislative
|
0014| appropriations;
|
0015| B. include provisions for cash benefits, payments to
|
0016| vendors on behalf of recipients and other noncash benefits; and
|
0017| C. are not more restrictive than permitted by federal
|
0018| law."
|
0019| Section 5. Section 27-2-6.2 NMSA 1978 (being Laws 1988,
|
0020| Chapter 122, Section 1) is amended to read:
|
0021| "27-2-6.2. [PUBLIC ASSISTANCE] AID TO FAMILIES WITH
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0022| DEPENDENT CHILDREN--EMPLOYMENT, [AND] TRAINING AND COMMUNITY
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0023| SERVICE ELIGIBILITY REQUIREMENTS--STATUS OF RECIPIENTS.--
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0024| [A. In the administration of all food stamp employment
|
and training programs, community work experience programs, work
|
incentive demonstration programs for recipients of aid to families
|
with dependent children and all other work registration, work
|
incentive or employment and training programs established or
|
conducted by the human services department, participation of
|
recipients shall be voluntary except as prohibited by federal law
|
or when mandatory participation is a requirement in order to secure
|
federal funding for services provided.
|
B. Any waiver requests developed and submitted to the
|
federal government by the human services department for food stamp
|
employment and training programs, community work experience
|
programs, work incentive demonstration programs for recipients of
|
aid to families with dependent children and all other work
|
registration, work incentive or employment, education and training
|
programs shall include a voluntary program and may also include a
|
mandatory alternative.
|
C. The human services department shall promulgate
|
regulations which shall be published and made available for public
|
notice and comment which detail the criteria for mandatory
|
participation and exemptions in accordance with federal law and
|
regulations for persons in work, education, training, job search
|
and work experience programs administered by the human services
|
department prior to their implementation.
|
D. The human services department shall not place
|
persons in any community work experience or similar program unless:
|
(1) appropriate standards for health, safety and
|
other conditions applicable to the performance of work are met;
|
(2) the program does not result in displacement of
|
persons currently employed; and
|
(3) provision is made for transportation, day
|
care and other costs necessary and directly related to
|
participation in the program]
|
0007| A. Aid to families with dependent children is provided
|
0008| pursuant to regulations adopted by the department. These
|
0009| regulations shall include provisions:
|
0010| (1) authorizing the department to require as a
|
0011| condition of eligibility for a recipient the participation by a
|
0012| recipient in programs of employment, educational or training
|
0013| services or community services; and
|
0014| (2) that are no more restrictive than the federal
|
0015| law permits.
|
0016| B. The department shall not impose the condition of
|
0017| eligibility authorized pursuant to Paragraph (1) of Subsection A of
|
0018| this section on an applicant or recipient for assistance if:
|
0019| (1) the applicant or recipient is disabled as
|
0020| determined by regulations adopted by the department;
|
0021| (2) the applicant or recipient lacks financial
|
0022| resources for or has insufficient geographic access to adequate
|
0023| child care;
|
0024| (3) the applicant or recipient lacks financial
|
0025| resources for transportation costs or other costs directly related
|
0001| to participation in the program;
|
0002| (4) the applicant or recipient is sixty years of
|
0003| age or older;
|
0004| (5) a child under the age of one year is
|
0005| included in the household of an applicant or recipient who is the
|
0006| parent or stands in the relationship of parent to that child; or
|
0007| (6) the applicant or recipient is otherwise
|
0008| excluded from participation pursuant to regulations adopted by the
|
0009| department.
|
0010| C. The department shall not place an individual in or
|
0011| require an individual to accept employment pursuant to the
|
0012| provisions of Paragraph (1) of Subsection A of this section if the
|
0013| proposed employment:
|
0014| (1) is not in a work setting having adequate
|
0015| standards for health, safety and other conditions applicable to the
|
0016| performance of the work; or
|
0017| (2) would result in the displacement of an
|
0018| existing worker.
|
0019| D. A recipient who is employed, participating in a
|
0020| training or educational program or providing community services as
|
0021| a condition of eligibility for receipt of aid to families with
|
0022| dependent children is not an employee of the department for any
|
0023| purposes, except as may be otherwise provided in the Unemployment
|
0024| Compensation Law, and is not entitled to any employee benefits."
|
0025| Section 6. Section 27-2-9 NMSA 1978 (being Laws 1973,
|
0001| Chapter 376, Section 13) is amended to read:
|
0002| "27-2-9. PAYMENT FOR HOSPITAL CARE.--
|
0003| A. Consistent with the federal act, the department
|
0004| shall provide necessary hospital care for recipients of public
|
0005| assistance other than those eligible under the general assistance
|
0006| program authorized by Section [10 of the Public Assistance Act]
|
0007| 27-2-7 NMSA 1978. [The rate of] Payment for inpatient hospital
|
0008| services shall be [based either on the reasonable cost or the
|
customary cost of such services, whichever is less. In determining
|
reasonable cost under this section, the board shall adopt
|
regulations establishing a formula]:
|
0012| (1) at a reasonable rate established by
|
0013| regulations adopted by the department that are consistent with the
|
0014| federal act [The department shall apply that formula to determine
|
the amount to which each hospital is entitled as reimbursement for
|
providing in-patient hospital services]; or
|
0017| (2) if the hospital care is provided pursuant to
|
0018| a managed care contract, at a rate or in an amount determined as
|
0019| provided in that contract.
|
0020| B. To receive reimbursement for providing in-patient
|
0021| hospital services, a hospital shall file annually with the
|
0022| department [such] information as required by the department
|
0023| [may reasonably require to determine reasonable costs or the
|
hospital's customary cost of in-patient hospital services]
|
0025| pursuant to its regulations.
|
0001| C. [Any] A hospital entitled to reimbursement for
|
0002| in-patient hospital services [shall be] is entitled to a
|
0003| hearing, pursuant to regulations of the [board consistent with
|
applicable state law] department if the hospital disagrees with
|
0005| the department's determination of the reimbursement the hospital is
|
0006| to receive."
|
0007| Section 7. Section 27-2-12.3 NMSA 1978 (being Laws 1987,
|
0008| Chapter 269, Section 1) is amended to read:
|
0009| "27-2-12.3. MEDICAID REIMBURSEMENT [EQUAL PAY FOR EQUAL
|
PHYSICIANS', DENTISTS', OPTOMETRISTS', PODIATRISTS' AND
|
PSYCHOLOGISTS' SERVICES].--The [human services] department shall
|
0012| establish [a rate] reasonable rates by regulation for the
|
0013| reimbursement of [physicians, dentists, optometrists, podiatrists
|
and psychologists for] providers of services rendered to
|
0015| medicaid patients [that provides equal reimbursement for the same
|
or similar services rendered without respect to the date on which
|
such physician, dentist, optometrist, podiatrist or psychologist
|
entered into practice in New Mexico, the date on which the
|
physician, dentist, optometrist, podiatrist or psychologist entered
|
into an agreement or contract to provide such services or the
|
location in which such services are to be provided in the state]."
|
0022| Section 8. Section 27-2-12.6 NMSA 1978 (being Laws 1994,
|
0023| Chapter 62, Section 22) is amended to read:
|
0024| "27-2-12.6. MEDICAID PAYMENTS--MANAGED CARE.--
|
0025| A. The department shall provide for a statewide,
|
0001| managed care system to provide cost-efficient, preventive, primary
|
0002| and acute care for medicaid recipients [by July 1, 1995].
|
0003| B. The managed care system shall ensure:
|
0004| (1) access to medically necessary services,
|
0005| particularly for medicaid recipients with chronic health problems;
|
0006| (2) [to the extent practicable] maintenance of
|
0007| [the] a rural primary care delivery infrastructure;
|
0008| (3) that the department's approach is consistent
|
0009| with national and state health care reform principles; and
|
0010| (4) to the maximum extent possible, that
|
0011| medicaid-eligible individuals are not identified as such except as
|
0012| necessary for billing purposes.
|
0013| C. The department may exclude nursing homes,
|
0014| intermediate care facilities for the mentally retarded, medicaid
|
0015| in-home and community-based waiver services and residential and
|
0016| community-based mental health services for children with serious
|
0017| emotional disorders from the provisions of this section."
|
0018| Section 9. Section 27-7-16 NMSA 1978 (being Laws 1989,
|
0019| Chapter 389, Section 3, as amended) is amended to read:
|
0020| "27-7-16. DEFINITIONS.--As used in the Adult Protective
|
0021| Services Act:
|
0022| A. "abuse" means:
|
0023| (1) knowingly, intentionally or negligently and
|
0024| without justifiable cause inflicting physical pain, injury or
|
0025| mental anguish; or
|
0001| (2) the intentional deprivation by a caretaker or
|
0002| other person of services necessary to maintain the mental and
|
0003| physical health of an adult;
|
0004| B. "adult" means a person eighteen years of age or
|
0005| older;
|
0006| C. "appropriate facility" means any facility other than
|
0007| a jail or detention facility;
|
0008| D. "caretaker" means an individual or institution that
|
0009| has assumed the responsibility for the care of an adult;
|
0010| E. "conservator" means a person who is appointed by a
|
0011| court to manage the estate of a protected adult;
|
0012| F. "court" means the district court having
|
0013| jurisdiction;
|
0014| G. "department" means the [human services] children,
|
0015| youth and families department;
|
0016| H. "emergency" means that an adult is living in
|
0017| conditions that present a substantial risk of death or immediate
|
0018| and serious physical harm to himself or others;
|
0019| I. "exploitation" means an unjust or improper use of an
|
0020| adult's resources for another's profit or advantage, pecuniary or
|
0021| otherwise;
|
0022| J. "guardian" means a person who is a guardian of an
|
0023| incapacitated adult pursuant to a court order;
|
0024| K. "incapacitated adult" means any adult who
|
0025| demonstrates over time partial or complete functional impairment by
|
0001| reason of mental illness, mental deficiency, physical illness or
|
0002| disability, chronic use of drugs, chronic intoxication or other
|
0003| causes to the extent that he is unable to manage his personal care
|
0004| or he is unable to manage his personal property and financial
|
0005| affairs;
|
0006| L. "independent living arrangements" means a mode of
|
0007| life maintained on a continuing basis outside of a hospital,
|
0008| veterans' administration hospital, nursing home or other facility
|
0009| licensed by or under the jurisdiction of any state agency;
|
0010| M. "interested person" means any adult relative, any
|
0011| person who has an interest in the welfare of the adult to be
|
0012| protected under the Adult Protective Services Act or any official
|
0013| or representative of a protective services agency or of any public
|
0014| or nonprofit agency, corporation, board or organization eligible
|
0015| for designation as a protective services agency;
|
0016| N. "neglect" means failure of the caretaker of an adult
|
0017| to provide basic needs such as clothing, food, shelter, supervision
|
0018| and care for the physical and mental health for that adult or
|
0019| failure by an adult to provide such basic needs for himself;
|
0020| O. "protected adult" means an adult for whom a guardian
|
0021| or conservator has been appointed or other protective order has
|
0022| been made;
|
0023| P. "protective placement" means the transfer of an
|
0024| adult from independent living arrangements to a hospital, nursing
|
0025| home, domiciliary or residential care facility, or from one such
|
0001| institution to another;
|
0002| Q. "protective services" means the services furnished
|
0003| by the department or a protective services agency or its delegate,
|
0004| as described in Section 27-7-21 NMSA 1978; and
|
0005| R. "protective services agency" means a corporation,
|
0006| board or organization authorized by the department pursuant to the
|
0007| Adult Protective Services Act to furnish protective services to
|
0008| protected or incapacitated adults or to serve as conservators or
|
0009| guardians of protected or incapacitated adults upon appointment by
|
0010| a court."
|
0011| Section 10. REPEAL.--Sections 27-2-37 through 27-2-40 NMSA
|
0012| 1978 (being Laws 1980, Chapter 25, Sections 1 through 4, as
|
0013| amended) are repealed.
|
0014| Section 11. APPLICABILITY.--
|
0015| A. The provisions of this act shall apply to an
|
0016| individual submitting a new application for benefits after its
|
0017| effective date.
|
0018| B. The provisions of this act shall not apply to an
|
0019| individual already receiving benefits on July 1, 1996 but shall
|
0020| apply to that individual on the date of recertification for
|
0021| benefits for the individual occurring after July 1, 1996.
|
0022| Section 12. EFFECTIVE DATE.--The effective date of the
|
0023| provisions of this act is July 1, 1996.
|
0024|
|